Abstract
BackgroundRecent research suggests that pregnancy is a potentially safe option for couples with at least one HIV-infected adult. Data regarding provider discussion of fertility intentions with women living with HIV (WLWH) or in serodiscordant relationships is limited.MethodsWe conducted a cross-sectional self-administered survey of health professionals who provide HIV services to women in order to assess knowledge and behaviors regarding family planning options for HIV-infected women and serodiscordant couples.ResultsOf 77 respondents, 47(61%) met the inclusion criteria (health care provider who cares for WLWH). Approximately half (57%) of the participants indicated that they always or usually discuss contraception or fertility intentions with their HIV+ female patients of reproductive age. When asked to indicate their awareness of techniques to decrease HIV transmission risk among serodiscordant couples attempting pregnancy, most participants reported awareness of multiple options. Discussion of contraception or fertility intentions was not associated with provider gender, age, and experience in caring for HIV-infected patients, previous training in women’s health or provider’s awareness of options to decrease transmission risk.ConclusionsHIV providers in this study were knowledgeable of practices that can lead to safer conception and prevent HIV transmission among individuals in serodiscordant relationships but did not always discuss this information with their patients. Further research is needed to explore optimal methods for encouraging such conversations.
Highlights
As HIV has increasingly become a chronic medical illness and advances in medical care have substantially diminished the risk of mother-to-child HIV transmission (MTCT), [1] more women with HIV desire the cultural and social milestone of motherhood [2,3,4,5,6,7,8]
With improved options for safe conception and decreased likelihood of MTCT, there is greater potential for providers and patients to engage in patient-centered conversations on how women living with HIV (WLWH) can both achieve pregnancy safely and avoid perinatal transmission of HIV if desired [15,16]
18 This study demonstrates that providers have a high level of knowledge regarding options for WLWH and serodiscordant couples desiring conception though this is information is not always discussed with patients
Summary
As HIV has increasingly become a chronic medical illness and advances in medical care have substantially diminished the risk of mother-to-child HIV transmission (MTCT), [1] more women with HIV desire the cultural and social milestone of motherhood [2,3,4,5,6,7,8]. With improved options for safe conception and decreased likelihood of MTCT, there is greater potential for providers and patients to engage in patient-centered conversations on how women living with HIV (WLWH) can both achieve pregnancy safely and avoid perinatal transmission of HIV if desired [15,16]. Organizations such as the Centers for Disease Control and Prevention (CDC) and Infectious Diseases Society of America (IDSA) endorse discussion of fertility intentions and contraception with HIV-infected women [17]. Data regarding provider discussion of fertility intentions with women living with HIV (WLWH) or in serodiscordant relationships is limited
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