父亲与 HIV：家庭相关问题的考虑。
Fathers and HIV: considerations for families.
机构信息
University College London, Research Department of Infection and Population Health, London, UK.
出版信息
J Int AIDS Soc. 2010 Jun 23;13 Suppl 2(Suppl 2):S4. doi: 10.1186/1758-2652-13-S2-S4.
BACKGROUND
Fathers are intricately bound up in all aspects of family life. This review examines fathers in the presence of HIV: from desire for a child, through conception issues, to a summary of the knowledge base on fathers within families affected by HIV.
METHODS
A mixed-methods approach is used, given the scarcity of literature. A review is provided on paternal and male factors in relation to the desire for a child, HIV testing in pregnancy, fatherhood and conception, fatherhood and drug use, paternal support and disengagement, fatherhood and men who have sex with men (MSM), and paternal effects on child development in the presence of HIV. Literature-based reviews and systematic review techniques are used to access available data Primary data are reported on the issue of parenting for men who have sex with men.
RESULTS
Men with HIV desire fatherhood. This is established in studies from numerous countries, although fatherhood desires may be lower for HIV-positive men than HIV-negative men. Couples do not always agree, and in some studies, male desires for a child are greater than those of their female partners. Despite reduced fertility, support and services, many proceed to parenting, whether in seroconcordant or serodiscordant relationships. There is growing knowledge about fertility options to reduce transmission risk to uninfected partners and to offspring.Within the HIV field, there is limited research on fathering and fatherhood desires in a number of difficult-to-reach groups. There are, however, specific considerations for men who have sex with men and those affected by drug use. Conception in the presence of HIV needs to be managed and informed to reduce the risk of infection to partners and children. Further, paternal support plays a role in maternal management.
CONCLUSIONS
Strategies to improve HIV testing of fathers are needed. Paternal death has a negative impact on child development and paternal survival is protective. It is important to understand fathers and fathering and to approach childbirth from a family perspective.
背景
父亲在家庭生活的各个方面都紧密相连。本综述探讨了 HIV 环境下的父亲：从生育愿望、受孕问题，到总结有关受 HIV 影响家庭中父亲的知识基础。
方法
鉴于文献匮乏，采用混合方法。综述了与生育愿望、孕期 HIV 检测、父亲身份与受孕、父亲身份与药物使用、父亲支持与脱离、男性与男男性行为者（MSM）以及父亲对 HIV 存在下儿童发育的影响等相关的父亲和男性因素。利用文献综述和系统综述技术获取现有数据，报告了男男性行为者的育儿问题的原始数据。
结果
HIV 感染者有生育愿望。这在来自多个国家的研究中得到证实，尽管 HIV 阳性男性的生育愿望可能低于 HIV 阴性男性。夫妻的愿望并不总是一致，在一些研究中，男性对孩子的愿望大于其女性伴侣。尽管生育能力下降、支持和服务有限，但许多人还是选择了育儿，无论是在血清一致还是血清不一致的关系中。对于减少未感染者伴侣和后代的传播风险的生育选择，知识不断增加。在 HIV 领域，对一些难以接触的群体的生育和父亲身份愿望的研究有限。然而，对于男男性行为者和受药物使用影响的人，有一些特定的考虑因素。在 HIV 存在的情况下，需要管理和告知受孕，以降低感染伴侣和孩子的风险。此外，父亲的支持在母亲的管理中发挥作用。
结论
需要制定策略来提高父亲的 HIV 检测。父亲的死亡对儿童的发育有负面影响，而父亲的存活具有保护作用。了解父亲和父权制，并从家庭的角度看待分娩非常重要。
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