HIV and Pregnancy Planning Guidelines Rev Up For Release

Why would a couple challenged by HIV be refused fertility services or comprehensive information about getting pregnant? Sometimes it’s stigma more than science, fueled by a lack of knowledge of care providers themselves, according to Dr. Mona Loutfy and Shari Margolese. Loutfy (Women’s College Research Institute) and Margolese (researcher/ writer/ activist) are the driving forces behind the development of the National HIV Pregnancy Planning Guidelines.

Not only are these guidelines going to be a great support to couples or singles living with HIV who wish to become parents, but they will also provide valuable information to service providers in general practice, HIV care, gynecology and fertility clinics.

As part of the project, two workshops are being developed: one for pos people and their partners, and one for service providers. They were piloted here in Vancouver at the end of September. To get input on whether the workshops are hitting the mark, Positive Women’s Network hosted the group for positive men and women who might be interested in becoming parents as well as women who already had children who could provide the “I wish I’d known….” perspective. The group for service providers was held at BC Women’s Hospital and Health Centre. One of the topics that came up in both was, not surprisingly, the stigma of living with HIV and becoming parents.

Becoming a parent when you’re HIV positive is still very often an experience in discrimination, on many levels. I’ve heard people say having children is either stupid or selfish (or both). Yet HIV treatments taken during pregnancy can reduce the probability of infection to less than 1%. And with HIV treatments extending people’s lives in ways we never could have imagined, seeing a child grow up is becoming less of a dream and more reality. I know a woman who’s had HIV for 20 years- she’s seen her kids grow up and become a grandmother herself.

Studies certainly indicate that positive women want to have children. In response to an Ontario survey on fertility intentions, 69% of 475 women responded they would like to give birth. A previous study in BC had shown that positive women’s fertility intentions were similar to women who didn’t have HIV. In other words, HIV wasn’t stopping their dreams.

In serodiscordant couples, risk reduction in getting pregnant depends on which one is positive. If the woman is positive and her partner isn’t, at home insemination can be done with no risk to the male partner at all (see more on our Pregnancy and HIV page). When the man, or both partners are positive, the scenario’s a little different. Some couples stress themselves out about risk as they try it at home with timed insemination (right around when a woman ovulates) or unsafe sex. The pregnancy planning guidelines will provide information for people to assess the level of risk they’re willing to take in their pursuit of parenthood.
 
Going to a fertility clinic can reduce risk. If the man is positive, sperm washing and intrauterine insemination is an option (a process that separates sperm from seminal fluid. Seminal fluid is what carries HIV). Sperm washing and intrauterine insemination have been done in Europe for years, using PCR technology to test the washed sperm for HIV. Several clinics in Ontario provide these services. In BC, the options are fewer, but Oak Tree Clinic can help you connect with care if fertility tests indicate you might need help. Fertility treatments aren’t covered by the Medical Services Plan.

At the session for service providers, Dr. Deborah Money of Oak Tree Clinic said that people are getting pregnant regardless, and making sure they have the best info available ensures the best outcomes for the whole family. The new guidelines will provide info about reducing the risks as much as possible, and make connections to services that will provide support and not censure.

Look for information sheets soon on the Canadian AIDS Treatment Information Exchange. In the meantime, you can visit our Pregnancy and HIV page, get our HIV and Pregnancy: Yes You Can! pamphlet or You Can Have A  Healthy Pregnancy if You’re  HIV-Positive booklet written by Shari. For more information on supportive pregnancy planning here in BC, contact Oak Tree Clinic: 604-875-2212.

 - Janet

This was posted on Friday, October 8th, 2010 at 9:00 am and is filed under Education & Resources, HIV pregnancy, HIV Prevention, HIV Transmission, News, Support . Feel free to respond, or trackback. Read our comments policy.

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