Back ground: The introduction of highly active antiretroviral therapy has changed thernlife prospect of PLWHA towards parenthood. However, little is known about the extentrnof PLWHA desire to have children.rnObjective: The aim of this study is to assess the desire to have children and identifyrnfactors associated with desire to have children among men and women living withrnHIV/AIDS at follow up of ARV treatment units.rnMethod: A crossâ€“sectional facility based study was conducted; using a pre testedrnstructured questionnaires on sample of HIVâ€“infected men and women attending at ARVrntreatment sites in Mekelle hospital and three health centers in Mekelle town. Total samplernsizes of 367 respondents were selected using systematic random sampling technique.rnRespondents were selected proportional to the size of each facility serving ARVrntreatment. Data were analyzed using SPSS statistical soft ware version 15.0. Ethicalrnclearance was obtained from the Medical Faculty of Addis Ababa University.rnResult: Data were obtained from 367 respondents, yielding a response rate 98.9%. Onernhundred forty four (39.2%) of respondents had desire to have children. Among men thisrnproportion was 43.6% (n=61), in contrast to 36.6 (n=83) of women. Generally desire tornhave children was higher in the age group 20-29 years compared to elderly age grouprnwith OR 10.48 (95% CI: 5.07, 21.63). Respondents who disclosed their HIV status torntheir partners had significant association for desire to have children compared to thosernwho do not disclosed with OR 1.67 (95% CI: 1.00, 2.80).rnConclusion A significant proportion of HIV infected individuals have desire for children.rnIssues related to fertility desires need to be addressed more frequently by health carernproviders to their HIV-infected clients through counseling to facilitate informed decision-rnmaking about child bearing.