About one in four women who have tested positive for the human immunodeficiency virus (HIV) expect pregnancy and motherhood to be a part of their future, recent research suggests.
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.