Approximately a third of people with HIV plan to have children

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Approximately a third of women infected with HIV intend to have children, according to a French study, a finding broadly in line with a similar Canadian study. Both studies are published in a supplement to the January 2nd edition of AIDS.

The French study also looked at the attitudes towards fatherhood of heterosexual men with HIV and found that a fifth expected to have children in the future.

French investigators designed a study involving 555 women and 699 men of reproductive age who were HIV-positive and identified themselves as heterosexual. They were asked to complete a questionnaire asking them about their desire for a child. The average age of the participants was 36 for the women and 41 for the men.

Glossary

serodiscordant

A serodiscordant couple is one in which one partner has HIV and the other has not. Many people dislike this word as it implies disagreement or conflict. Alternative terms include mixed status, magnetic or serodifferent.

Although the men were more likely to be on antiretroviral therapy than the women, the percentage of those saying they felt in ‘good health’ was similar for both sexes - 60% for men and 58% for women.

Thirty-three percent of the women and 20% of the men said they expected to have children. Factors which made that desire more likely in both groups included being younger, already being a parent, being in a regular relationship and having a partner who was HIV-negative.

Most of the men and women were born in France, but 30% of women and 15% of men were born in sub-Saharan Africa and being of African ethnicity significantly increased the likelihood that a participant expected to have children. African men were four times more likely and African women up to six times more likely to desire to have children.

HIV-related health status was not significantly related to the desire to have a child.

The Canadian study was smaller and asked 230 HIV positive women in British Columbia about their desire to become pregnant and found 26% of them expected to have children.

Reflecting some of the conclusions of the French study, the Canadian researchers found that women who say they intend to have children tend to be younger and more likely to have a regular partner.

The Canadian researchers compared their results to a recent survey using the same methodology in the general Canadian population which found that 37.5% of women intended to have children in the future. They say HIV positive women want children at levels “approaching those among the general population” and that public policy planners and health professionals need to plan for the implications of increasing numbers of women with HIV who choose to have children.

The French authors conclude that as awareness of options for the prevention of HIV transmission from mother to infant grows it is likely that more women will choose to become pregnant “in the near future”.

The more widespread use of assisted reproductive techniques which make conception easier for serodiscordant couples will also make parenthood more possible for people living with HIV and AIDS.

References

Heard I et al. Reproductive choice in men and women living with HIV: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA Study). AIDS 21:S77-S82, 2007.

Ogilvie GS et al. Fertility intentions of women of reproductive age living with HIV in British Columbia, Canada. AIDS 21:S83-S88, 2007.