ackground: HIV positive individuals may or may not have intention to have children. Theyrncould also have different degrees of utilization and demand for family planning. The extent ofrnthe intention and how it varies by individual, social, health and demographic characteristics isrnnot well understood. The desire of HIV infected persons to have children in the future hasrnsignificant implication for the transmission of HIV to sexual partners or newborns. So this studyrncontributes a lot for program planners.rnObjective of the study: to determine the fertility desire and contraceptive utilization amongrnPLWHAs in ART follow up care in Hossana hospital and health center.rnMethodology: A cross sectional institution based study design supplemented by qualitative indepthrninterview was done between December to May 2010rnThe study was conducted in Hosanna Town (Hospital and health center), Hadiya zone, SouthernrnEthiopia. The study population were all PLWHA who had at least one visit to the selected ARVrntreatment units and age group 18- 49 for women and 18-59 for men and the sample size takenrnwere 321 and selected using quota sampling technique. Pre-tested questionnaire was used torncollect the data which was entered using EPI info window 2000 and analyzed by SPSS 11.0rnstatistical packages. The qualitative study sample depended on the level of saturation ofrninformation and interview includes respondents, health care provider working in PMTCT, VCT,rnART and FP department. Purposive sampling was applied to select study subjects from eachrninstitution. Tape record is used then transcribed to meaningful phrases, data were grouped in tornthematic area and words of the respondents were quoted accordingly.rnResult: Thirty-six (37.9%) male and eighty one (35.8%) female respondents expressed the desirernfor children, giving a total of 117 (36.45%) of all respondents. In general PLWHAs whornintended to have children were those PLWHAs having no children (Adjusted OR 60.89, 95% CIrn8.02, 462.05). Those who intended to use family planning in the future were more likely to desirernchildren (Adjusted OR 4.35, 95% CI 1.61, 11.73) than their counter parts. But if partner decidernnot to have children they were less likely to desire (lower desire) for children (Adjusted OR 0.02,rn95%CI 0.001, 0.41). Thirty-six (37.9%)men and 66(29.2%) women, overall 102(31.8%) werernusing family planning during the study period. Factors associated with family planning use werernbeing married (Adjusted OR 7.83, 95%CI 1.08, 56.79), having three or more children (AdjustedrnOR 4.54, 95%CI 1.12, 18.48), and having knowledge on mother to child transmission (AdjustedrnOR 4.29, 95%CI 1.98, 9.26) and plan to have children in the future (Adjusted OR 0.29, 95%CIrn0.1, 0.82) were less likely to use family planning than their counter parts.rnConclusion and RecommendationrnA high proportion of HIV positive individuals who received medical care expressed a desire forrnchildren. The extent of fertility intention and family planning needs of these people hasrnimplication for vertical, heterosexual transmission and need consideration. A better and evidencernbased understanding of fertility intentions and demand for contraception is needed to promoternand protect the rights of women and men living with HIV/AIDs to make informed decisionsrnabout reproduction and to have access to appropriate sexual reproductive health services.