Many HIV-positive women hope for pregnancy
Published Monday, December 7, 2009 9:14AM EST
Most HIV-positive women of child-bearing age want to become pregnant at some point, finds a new study that points to the need for more support for these women.
The study, published online in the journal PLoS One, looked at HIV-positive women in Ontario. It found 69 per cent of those who responded to a detailed questionnaire had a desire to have a baby, while 57 per cent said they actually intend to become pregnant.
The findings do not surprise Shari Margolese, an HIV-positive mother herself.
"Being HIV-positive certainly doesn't change your desire to have all of the things in your life that anyone else in the general population would want. And that includes having relationships and having children," she told CTV's Canada AM Monday.
Margolese found out she had HIV 17 years ago, when her baby was three months old. Since then, she has become an active campaigner for families living with HIV.
She says when she was diagnosed in 1993 at the age of 30, she still wanted more children but never actually tried to become pregnant because she knew the decision would not be well received.
"There was so much stigma surrounding having children when you have HIV. Now that a lot of that stigma is going away, and there is better treatment and care and support, my intentions now would probably be higher," she said.
Trevor Hart, a clinical psychologist and a senior author of the PLoS study says even 30 years into the fight against AIDS, there are still misconceptions about HIV and pregnancy -- particularly about the risk is of transmitting HIV during pregnancy and birth.
"Even women who have no access to HIV medications have only a one-in-four chance of giving birth to an HIV-positive baby," he told Canada AM. "With medications, the chances are now less than 1 per cent."
Women can reduce their chances of so-called "vertical transmission" -- transmission from mother to fetus or newborn -- if they receive appropriate drug treatment during the pregnancy, deliver by caesarean section where appropriate and skip breastfeeding.
Hart says that the survey found that HIV-positive women who intended to have kids were more likely:
- to be younger (the survey included women aged 18 to 52)
- to have never been married
- to be of African background
- to have been born outside of Canada
- to have been living in Toronto (that may be related to the fact that there are more services for HIV-positive women in Toronto compared to other places in Ontario)
Each year in Canada, about 200 babies are born to women with HIV. Only a handful are born HIV-positive and of them, almost all are born to women who did not get HIV medications before and during their pregnancies or did not know they were infected.
While HIV-AIDS once meant a death sentence, antiretroviral medications have completely changed that, so that people with HIV can live long lives, in some cases as long as people in the rest of the population.
While 30 years ago, an HIV-positive woman focused only on survival, nowadays, they can have the same dreams other women have.
Despite the advances, Margolese says, many women with HIV meet with resistance when they go their doctors to ask for help with having a healthy pregnancy.
"A lot of women who come to me are looking for a physician who will be friendly and available to assist them in getting pregnant safely, both around transmission to their partner -- because many of the women don't have HIV-positive partners -- and of course to their baby," she said.
Hart said he too has seen evidence that the medical community remains reticent to encourage women with HIV to consider pregnancy.
"We have evidence from other studies that a lot of HIV-positive women are not getting appropriate care, that sometimes medical practitioners are not as well-informed as they could be," he said.
"So if we can let doctors know that HIV-positive women do expect to have kids, then they can work with the medical community to provide opportunities for HIV-positive women to do the other things that other women like to do."