Center for Culture and Health, Department of Psychiatry and Behavioral Sciences, NPI-Semel Institute for Neuroscience, University of California, Los Angeles, CA 90024-1759, USA.
Matern Child Health J. 2013 May;17(4):593-600. doi: 10.1007/s10995-012-1035-6.
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.
联合抗逆转录病毒疗法（combination antiretroviral therapy）为艾滋病毒/艾滋病（HIV/AIDS）感染者（persons living with HIV/AIDS，PLHA）延长了预期寿命，并使他们能够过上富有成效的生活，包括生育子女。尽管有人呼吁关注 PLHA 的生育问题，但针对安全妊娠项目的关注有限。这项研究旨在评估 PLHA 的生育愿望以及为这一人群服务的医疗保健提供者的经验。研究包括在洛杉矶县的两个诊所，对 18 岁以上的 HIV 感染者进行为期 8 周的简短横断面客户调查。在每个诊所地点与提供者进行焦点小组讨论。尽管接受调查的 93 名客户中有 39%表示希望生育孩子，但三分之二的客户尚未与提供者讨论过他们的愿望或安全妊娠的方法。提供者报告说，在资源匮乏的环境中，他们在提供安全妊娠服务方面面临挑战，因为客户无法负担辅助生育服务，而且缺乏国家、州或县的安全妊娠指南。他们指出了复杂多样的客户情况，以及提供者在安全妊娠方面培训的迫切需要。需要制定关注安全妊娠和减少伤害策略以及咨询这些实践的法律后果的指南。HIV 提供者需要培训，患者需要教育工具和研讨会，让他们了解风险、挑战以及为他们自己和伴侣安全妊娠和生育 HIV 阴性儿童的可用选择。
