Discussing parenthood with gay men diagnosed with HIV: a qualitative study of patient and healthcare practitioner perspectives

Robert Pralat,Tristan J Barber,Elizabeth Yarrow,Jane Anderson,Fiona Burns

doi:10.1186/s12889-021-12285-4

Abstract

BackgroundResearch on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate.MethodsQualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20–45, who did not have children, and 16 HIV clinicians. A thematic analysis identified potential reasons why parenthood was rarely discussed with gay men in HIV care.ResultsTwo sets of ideas contributed to a lack of conversations about parenthood: clinicians’ ideas about what matters to gay men and men’s ideas about what it means to be HIV-positive. Both sets of ideas largely excluded having children, with patients and practitioners similarly unlikely to raise the topic of parenthood in the clinic. Contrary to what clinicians commonly assumed, many men expressed interest in receiving more information, highlighting the importance of reassuring people upon diagnosis that it is possible to become parents while living with HIV.ConclusionsParenting desires and intentions were rarely discussed with men in HIV care. Our findings illuminate the potentially beneficial effects of emphasising that having children is a possibility at diagnosis, regardless of patients’ gender or sexuality. Conveying this information seems meaningful, not only to men who want to become parents in the future but also to others, as it appears to alleviate fears about mortality and ill health.

Highlights

Research on HIV and reproduction has focused largely on women and heterosexual men
Interviews ended up focusing to a large extent on biological parenthood, which did not necessarily reflect the men’s interests in pursuing it. In our interviews, both HIV clinicians and men living with HIV confirmed what would be expected based on existing research: discussing parenthood with gay men in HIV care was not common
We show how two sets of ideas contributed to the absence of conversations about parenthood: clinicians’ ideas about what matters to gay men and men’s ideas about what it means to live with HIV

Summary

Introduction

Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate. There is a substantial amount of research exploring reproductive desires, intentions and decision-making among people living with HIV, including studies from Europe [1,2,3,4], South Africa [5, 6] and the United States [7,8,9,10] that pertain to men or incorporate. In many countries, such as the UK, increasing numbers of gay men are deciding to become parents. Apart from a small number of memoirs written by HIV-positive gay fathers who have adopted [24], there is little discussion in the existing literature about the role HIV plays in gay men’s decisions to become parents or remain childfree

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Results

Discussion

Conclusion