The reproductive careers of a cohort of men and women following an HIV-positive diagnosis

Abstract

This report examines the consequences of a positive HIV diagnosis upon the reproductive decision-making of 39 men and women in Scotland. Whilst the majority initially decide never to have any (more) children this sometimes changes as other factors gain ascendancy, such as a partner wanting 'their' child, and about one-third had had a child or were intending to do so. The motivations underlying such decisions are discussed and ways in which health services could intervene to support people with HIV in making reproductive choices and to minimise the risk of transmission to an HIV-negative partner and the child are suggested.

Reproductive Decision‐Making Among HIV‐Positive Couples in Taiwan

“…Couples indicated that their reproductive health tended to be ignored or neglected by providers unless the couples were diagnosed with HIV infection during pregnancy. This finding is consistent with previous studies in the US showing that HIV‐positive women perceived that health care professionals were not willing to discuss reproductive options with them, assumed they did not have sexual lives, or discouraged them from continuing childbearing (Bruyn, 2002; Green, 1994; Sowell & Misener, 1997). Couples in this study actively searched for information that would help them make their own decisions about their pregnancies.…”

Unconventional conceptions and HIV

“…O ur previous research had explored attitud es toward s sex and reproduction am ong young heterosexual m en and wom en (W ight, 1993; K itzinger, 1995) and people with H IV (Green, 1994). In the light of th is wo rk, we becam e interested in interviewing wom en seeking sperm .…”

“…W ight' s work with young m en from a working class locality of G lasgow dem onstrate d that HIV was not an issue in th eir reproductive decisions and that, in any case, they tended to assum e that only certain typ es of people (such as`slags' and`junkies' ) were liable to be infected (W ight, 1993; see also M aticka-T yndale, 1992; and W oodcock et al, 1992). G reen' s research show ed that, even given the risk of H IV transm ission, som e people in long-te rm com m itted relationships were willing to go ahead and try to conceive with their H IV-positive partners because they speci® cally wanted to have their child (Green, 1994). O ther research has show n how the value of personal relationships, such as group solidarity or affection and trust betw een partners, often overrides concern with H IV infection (e.g.…”

“…W e anticipated that the circum stan ces surrounding the search for sperm m ight em pow er wo m en to consider options and m ake choices th at were not considered by, or not available to, other wom en. A wo m an who could becom e pregnant by her husb and or boyfriend wo uld be unlikely to consider anyone else to fathe r her child and, as Green (1994) show ed, m ay even choose him as th e biological fathe r in spite of knowing him to be H IV-positive. However, wo m en seeking sp erm m ight have a wider choice of potential donors and be less likely to be limited by affective ties to only one source of sperm .…”

“…Other general factors Som e of the wom en failed to consider the risks of HIV for m any of the sam e reasons as th ose interviewed in the other research projects (Green, 1994;K itzinger, 1995). O ne wom an said she had th ought of H IV as ª an A m erican problem º .…”