Azemar F Hopker, Daudin M, Bujan L
Service de néonatologie, hôpital des Enfants, CHU de Toulouse, Toulouse, France.
Gynecol Obstet Fertil. 2010 Jan;38(1):58-69. doi: 10.1016/j.gyobfe.2009.05.012. Epub 2009 Dec 22.
Assisted Reproductive Technologies for serodiscordant couples with HIV-infected male partner has been possible since 2000 in French centres such as the CECOS in Toulouse. From the outset, couples in the program meet psychologists or psychiatrists. In the first instance, the results from 40 psychologist led interviews with serodiscordant couples held at the CECOS in Toulouse, identified several challenging ideas. Couples who plan to have children were in a stable long-term relationship and both were involved in managing the illness. Medically assisted procreation awakens in the women a strong desire for children and enables the couples to make plans for the future. But it also reminds the men of their reliance on medical assistance because of the demands made by the medical program, and in case of failure it can destabilise the couples' way of coping with HIV. Subsequently, interviews with 12 couples during pregnancy revealed the overbearing presence of the illness, despite the imminent birth of the desired child. In their responses, women express their anxiety concerning the risk of contamination, and the defences that the men had built up to cope with HIV appeared destabilised, now that the idea of their death is rekindled.
自2000年起,在法国图卢兹的CECOS等中心,为男性伴侣感染艾滋病毒的血清学不一致夫妇提供辅助生殖技术成为可能。从一开始,该项目中的夫妇就会与心理学家或精神科医生会面。首先,在图卢兹CECOS对40对血清学不一致夫妇进行的由心理学家主导的访谈结果,确定了几个具有挑战性的观点。计划要孩子的夫妇处于稳定的长期关系中,双方都参与疾病管理。医学辅助生殖在女性心中唤起了强烈的生育愿望,并使夫妇能够为未来制定计划。但这也让男性意识到由于医疗程序的要求,他们依赖医疗援助,而且一旦失败,可能会破坏夫妇应对艾滋病毒的方式。随后,在孕期对12对夫妇进行的访谈显示,尽管期待已久的孩子即将出生,但疾病的影响却无处不在。在她们的回答中,女性表达了对感染风险的焦虑,而男性为应对艾滋病毒所建立的防御机制似乎受到了动摇,因为他们死亡的想法再次被点燃。