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Fertility Desires Among HIV-Infected Men and Women in Los Angeles County: Client Needs and Provider Perspectives

Maternal and Child Health Journal volume 17, pages 593–600 (2013)Cite this article

Abstract

Combination antiretroviral therapy for persons living with HIV/AIDS (PLHA) has extended life expectancy, and enabled PLHA to live productive lives that can include having children. Despite calls to address childbearing for PLHA there has been limited attention to developing safe conception programs. This research sought to assess the childbearing desires of PLHA and the experiences of health care providers serving this population. Research entailed a brief cross-sectional client survey given to HIV-infected men and women over age 18 at two Los Angeles County clinics administered over an 8-week period. Focus group discussions were conducted with providers at each clinic site. Although 39 % of the 93 clients surveyed reported a desire to have children, two-thirds of clients had not discussed their desires, or methods of safe conception, with providers. Providers reported challenges in providing safe conception services in resource poor settings where clients cannot afford assisted fertility services and in the absence of national, state, or county guidelines for safe conception. They noted complex and varied client circumstances and a critical need for provider training in safe conception. Guidelines that focus on safe conception and harm reduction strategies as well as the legal ramifications of counseling on these practices are needed. HIV providers need training and patients need educational tools and workshops informing them of the risks, challenges, and options available to them and their partners to safely conceive and bear an HIV-negative child.

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Acknowledgments

We would like to thank clinic leadership as well as the staff at the Valley Community Clinic (VCC) and the To Help Everyone (THE) Clinic for their support and assistance with the study. We also gratefully acknowledge the patients who participated in the study.

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Authors and Affiliations

  1. Center for Culture and Health, Department of Psychiatry and Behavioral Sciences, NPI-Semel Institute for Neuroscience, University of California, 760 Westwood Plaza, P.O. Box 62, Los Angeles, CA, 90024-1759, USA

    Deborah Mindry

  2. RAND Institute, Santa Monica, CA, USA

    Glenn Wagner, Amber Smith & Sebastian Linnemayr

  3. Division of Infectious Diseases and Center for Clinical AIDS Research and Education, David Geffen School of Medicine at University of California, Los Angeles, CA, USA

    Jordan Lake, Molly Quinn & Risa Hoffman

Authors
  1. Deborah Mindry
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  2. Glenn Wagner
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  3. Jordan Lake
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  4. Amber Smith
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  5. Sebastian Linnemayr
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  6. Molly Quinn
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  7. Risa Hoffman
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Corresponding author

Correspondence to Deborah Mindry.

Appendix: Survey on Fertility Desires and Reproductive Health Services

Appendix: Survey on Fertility Desires and Reproductive Health Services

Thank you for completing the survey. If you have had a child since testing HIV+, or if you are currently trying to have a child or have desires to have a child, and you would be willing to participate in a focus group with others HIV clients like yourself, please inform the clinic staff member who gave you this survey or your provider of your interest. Please note that your participation in this focus group is completely voluntary.

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Mindry, D., Wagner, G., Lake, J. et al. Fertility Desires Among HIV-Infected Men and Women in Los Angeles County: Client Needs and Provider Perspectives. Matern Child Health J 17, 593–600 (2013). https://doi.org/10.1007/s10995-012-1035-6

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  • DOI: https://doi.org/10.1007/s10995-012-1035-6

Keywords

  • Safe conception
  • HIV
  • United States
  • Fertility intentions
  • PLHA