Abstract
Combination antiretroviral therapy for persons living with HIV/AIDS (PLHA) has extended life expectancy, and enabled PLHA
to live productive lives that can include having children. Despite calls to address childbearing for PLHA there has been limited
attention to developing safe conception programs. This research sought to assess the childbearing desires of PLHA and the
experiences of health care providers serving this population. Research entailed a brief cross-sectional client survey given
to HIV-infected men and women over age 18 at two Los Angeles County clinics administered over an 8-week period. Focus group
discussions were conducted with providers at each clinic site. Although 39 % of the 93 clients surveyed reported a desire
to have children, two-thirds of clients had not discussed their desires, or methods of safe conception, with providers. Providers
reported challenges in providing safe conception services in resource poor settings where clients cannot afford assisted fertility
services and in the absence of national, state, or county guidelines for safe conception. They noted complex and varied client
circumstances and a critical need for provider training in safe conception. Guidelines that focus on safe conception and harm
reduction strategies as well as the legal ramifications of counseling on these practices are needed. HIV providers need training
and patients need educational tools and workshops informing them of the risks, challenges, and options available to them and
their partners to safely conceive and bear an HIV-negative child.
to live productive lives that can include having children. Despite calls to address childbearing for PLHA there has been limited
attention to developing safe conception programs. This research sought to assess the childbearing desires of PLHA and the
experiences of health care providers serving this population. Research entailed a brief cross-sectional client survey given
to HIV-infected men and women over age 18 at two Los Angeles County clinics administered over an 8-week period. Focus group
discussions were conducted with providers at each clinic site. Although 39 % of the 93 clients surveyed reported a desire
to have children, two-thirds of clients had not discussed their desires, or methods of safe conception, with providers. Providers
reported challenges in providing safe conception services in resource poor settings where clients cannot afford assisted fertility
services and in the absence of national, state, or county guidelines for safe conception. They noted complex and varied client
circumstances and a critical need for provider training in safe conception. Guidelines that focus on safe conception and harm
reduction strategies as well as the legal ramifications of counseling on these practices are needed. HIV providers need training
and patients need educational tools and workshops informing them of the risks, challenges, and options available to them and
their partners to safely conceive and bear an HIV-negative child.
- Content Type Journal Article
- Pages 1-8
- DOI 10.1007/s10995-012-1035-6
- Authors
- Deborah Mindry, Center for Culture and Health, Department of Psychiatry and Behavioral Sciences, NPI-Semel Institute for Neuroscience, University of California, 760 Westwood Plaza, P.O. Box 62, Los Angeles, CA 90024-1759, USA
- Glenn Wagner, RAND Institute, Santa Monica, CA, USA
- Jordan Lake, Division of Infectious Diseases and Center for Clinical AIDS Research and Education, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Amber Smith, RAND Institute, Santa Monica, CA, USA
- Sebastian Linnemayr, RAND Institute, Santa Monica, CA, USA
- Molly Quinn, Division of Infectious Diseases and Center for Clinical AIDS Research and Education, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Risa Hoffman, Division of Infectious Diseases and Center for Clinical AIDS Research and Education, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875