A woman’s age at the time she learns of her HIV status appears to influence this decision. Women in an Ohio State University study who learned of their HIV infection when they were under age 30 were almost four times more likely to say they wanted to become pregnant than were women who were over 30 when they learned they had HIV.
Researchers say the findings point to a need for clinicians to be aware that women with HIV might be struggling with decisions about motherhood – a relatively new phenomenon accompanying the increase in HIV-positive women of childbearing age and the longer survival rates among patients who receive treatment.
“We shouldn’t assume that women aren’t going to become pregnant or don’t want to become pregnant now that they have HIV. That’s an erroneous assumption,” said study co-author Julianne Serovich, professor and chair of human development and family science at Ohio State. “Clinicians should be routinely discussing pregnancy with HIV-positive women of childbearing age.”
In 2005, 29.5 percent of all new reported HIV infections and 27 percent of new AIDS cases in the United States were among women, according to the Centers for Disease Control and Prevention. Twenty years earlier, only 5 percent of new AIDS cases were reported in women. HIV is the virus that causes AIDS.
The study is published in a recent issue of the journal AIDS and Behavior.
The researchers collected questionnaires about pregnancy decisions from 74 women who were participants in a larger, long-term study led by Serovich that explored women’s HIV disclosure decisions and mental health. This particular line of research emerged from interviewers’ observations that participants were talking about pregnancy and, in some cases, becoming pregnant. Simultaneously, health care professionals were sharing stories with researchers about the women’s success in avoiding transmission of the HIV virus to their babies.
“It became obvious that this is a disease that is manageable for women,” said lead study author Shonda Craft, who completed the research while she was a doctoral candidate at Ohio State.
“If a woman is 19 years old and diagnosed with HIV, she can still assume she has her whole life ahead of her. Deciding whether to have a family is part of the development process for young women, including these young women,” said Craft, now an assistant professor of family social science at the University of Minnesota. “This study is about living with a chronic disease, and not just the physiological piece of that, but also the psychological and sociological factors, as well.”
Women in the study were asked to quantify how influential several factors were on their decision about whether or not to become pregnant after their HIV diagnosis.
Aside from external influences, age emerged as a major factor in the choice. Nearly 40 percent of women age 30 and younger chose to become pregnant while 11 percent of the women over 30 opted for pregnancy.
The most influential external factors on women’s choices against pregnancy, regardless of age, were fear of transmitting HIV to a child or other concerns about preserving their own health. Conversely, a powerful personal desire to have children was associated with a woman’s choice to become pregnant.
Within the women’s social network, medical personnel had the strongest influence on their decisions about pregnancy – either for or against having a baby.
Though there are no guarantees of safely conceiving and delivering a healthy baby for women with HIV, the medical community has found ways to reduce health risks for both mother and child, said Michael Brady, professor and chair of pediatrics at Ohio State and a co-investigator on the study’s funding grant. Women who are HIV-positive should receive antiretroviral medications throughout their pregnancy and during labor, and their newborns should receive antiretroviral medication for the first six weeks of life. Delivery by Caesarean section also can reduce risk of transmission of the virus to the infant, but should be performed if required for the mother’s health or if the mother’s level of virus in the blood is high. With optimal care, the risk of transmission can be as low as 1 percent, Brady said.
There is also a risk associated with conception of the child, Brady noted. Though transmission of HIV from an infected woman to an uninfected male partner is not universal during unprotected sex, it can happen. Even if both partners are already infected with HIV, an infected male partner might transmit a new strain of HIV to his infected female partner, which can cause problems for the mother and fetus as well.
“We don’t understand all of the factors that affect the risk of transmitting HIV with an individual sex act. Taking medications and lowering the viral load reduces but doesn’t eliminate the risk. Some people interested in having a child may be willing to accept this risk. But there is a risk,” Brady said.
One finding of the study surprised the researchers. Women who had the most negative self-image associated with their HIV status were also the most likely to want to become pregnant.
“We would have predicted that the lower the stigma, the more likely women would choose to become pregnant. We saw the exact opposite – that those with high stigma were making more choices in favor of pregnancy,” Serovich said.
For some women who feel highly stigmatized by their disease, the rewards of pregnancy might offer therapeutic benefits, the researchers suggest.
“When you’re pregnant, you get lots of attention, people come up to you and touch your belly. You get a shower, people do things for you. There are certainly a lot of very positive repercussions of pregnancy that may help women feel better,” Serovich said.
Though much of Serovich’s earlier research focused on HIV-positive men, she sees a need for a deeper examination of issues facing women who are infected.
“There hasn’t been a lot of work done in this area and as women live longer and stay healthier, we need to know even more,” she said. “What is clear is that women can live with this and have many options.”
This study was funded by the National Institute of Mental Health.
Additional co-authors were Robin Delaney of human development and family science and Dianne Bautista of statistics, both at Ohio State.
Julianne Serovich | EurekAlert!
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
Satellites in near-Earth orbit are at risk due to the steady increase in space debris. But their mission in the areas of telecommunications, navigation or weather forecasts is essential for society. Fraunhofer FHR therefore develops radar-based systems which allow the detection, tracking and cataloging of even the smallest particles of debris. Satellite operators who have access to our data are in a better position to plan evasive maneuvers and prevent destructive collisions. From April, 25-29 2018, Fraunhofer FHR and its partners will exhibit the complementary radar systems TIRA and GESTRA as well as the latest radar techniques for space observation across three stands at the ILA Berlin.
The "traffic situation" in space is very tense: the Earth is currently being orbited not only by countless satellites but also by a large volume of space...
An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.
The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...
In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.
Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...
Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.
They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...
A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...
23.03.2018 | Event News
19.03.2018 | Event News
16.03.2018 | Event News
23.03.2018 | Materials Sciences
23.03.2018 | Agricultural and Forestry Science
23.03.2018 | Physics and Astronomy