Background: - Most people living with HIV/AIDS are in the childbearing age and face difficultrnchoices concerning their sexuality and childbearing. Improvements in life expectancy and qualityrnof life for HIV-positive women and men coupled with reduced vertical transmission will likelyrnlead numerous HIV-positive women and men to consider having a child. Their fertility desirernand reproductive health care needs of HIV positive individuals are changing as their health getrnimproved and the change in quality of life.rnObjective:-The objective of the study was to assess the fertility intentions and reproductivernhealth care needs of men and women living with HIV/AIDS in Nekemte town, East Wollega,rnEthiopia.rnMethods:-An institutional based comparative cross-sectional study was carried out among menrnand women living with HIV/AIDS from February to March 2010 on total sample of 592 inrnNekemte public health institutions. Patients who visited the health facility and fulfilled therninclusion criteria were interviewed consecutively. Data was collected using a pre-testedrnstructured questionnaires supplemented by qualitative in-depth interview. Quantitative data werernentered and cleaned by EPI info then exported to SPSS version 16 for analysis.rnResult: - About 36% (n=211) of respondents desired more children. Men were more to desirernchild than the women 120(40.5%) versus 91 (30.7%). Generally people who desire children arernbeing male (AOR: 1.706, 95%CI: 1.045-2.784), younger age 18-29 years (AOR: 3.493, 95%CI:rn1.644-7.424), age 30-39 years (AOR: 2.975, 95%CI: 1.477-5.991), having no living childrn(AOR: 13.140, 95%CI : 5.347- 32.289), having 1-2 living children (AOR: 4.157, 95%CI: 2.166-rn7.975), having partner who desire child (AOR: 15.402, 95%CI: 9.198-25.789), recent CD4 countrn 200 (AOR: 2.014, 95%CI: 1.158-3.502) were positively and significantly associated withrnfertility desire.rnAmong HIV positive women who desired children were younger age 18-24 years (AOR: 3.508,rn95%CI: 1.099-11.201), having no living child (AOR: 6.729, 95%CI : 1.958- 23.132), having 1-rn2 living children (AOR: 2.975, 95%CI: 1.139-7.767), having partner who desire child (AOR:rn17.430, 95%CI: 8.051-37.734), family size < 2 (AOR: 3.526, 95%CI: 1.469-8.459) werernpositively and significantly associated with womenâ€™s fertility desire.rnIIIrnAmong HIV positive men who desired children were younger age 18-29 years (AOR: . 3.030,rn95%CI: 1.218,7.537), age 30-39 years (AOR: 3.105, 95%CI: 1.408, 6.847), having no livingrnchild (AOR: 16.435, 95%CI : 4.281,63.093), having 1-2 living children (AOR: 4.652, 95%CI:rn1.943-11.134), having partner who desire child (AOR: 16.734, 95%CI: 8.200-34.150) werernpositively and significantly associated with men fertility desire.rnConclusion and recommendationrnMost PMTCT interventions have targeted women. However, men were more likely to desirernmore children than women, and men are often the decision makers in matters related tornreproductive choices. Under circumstances in which many HIV-infected individuals,rnintentionally or unintentionally, continue to have children, dealing openly with their fertilityrndesires make it to meet their reproductive health care needs. Patients who do not want to becomernpregnant require effective contraception. Those who desire children and are engaging inrnpregnancy risk behavior need education on the efficacy of PMTCT interventions which shouldrntarget men and male partner of HIV-infected women too.