Helping Women Living with HIV Plan Their Families: Forwarding the Research Agenda
August 10, 2010
Elizabeth and her son Nathan
The decision to start a family is a joyful one for most women, but also comes with some anxiety – will my pregnancy be normal? Will my child be healthy? For women living with HIV, particularly in resource-limited settings, these concerns are even more critical.
A new report addressing these concerns
issued by the Harvard Program on International Health and Human Rights
and the WHO
was just unveiled in Vienna at the 2010 International AIDS Conference
. It outlines a research agenda to support HIV-positive women and their partners to plan for healthy families and futures.
Like all women, those living with HIV face decisions about the right time to have a child and how many children they want. However, they have unique challenges because of the risks of mother-to-child transmission of the virus.
When I became pregnant, I gained a new perspective on the Foundation’s HIV programs. I get tested for HIV annually, but while doing routine testing during my first trimester of pregnancy, and again while in labor and delivery, I was overwhelmed with concern for my baby and wanted to do everything possible to make sure he was healthy.
While testing, I thought of the women I had met in clinics supported by the Foundation in Côte d’Ivoire, South Africa, Tanzania and Zambia. I thought of my favorite picture of Elizabeth Glaser that hangs in our office that shows her swimming with her daughter, Ariel. I thought these mothers I have met feel the same way I do. Our children should have bright, healthy futures, regardless of HIV status.
In the past, it was generally assumed that women living with HIV would no longer want to bear children. This has changed with the dramatic increase in access to antiretroviral treatment over the past decade. Now there is a much greater likelihood that women in the developing world will be able to have children born free of the virus.
Women living with HIV throughout the world are starting their families, but the research on how to provide the best information, tools, and services they need has lagged behind this new reality.
Elizabeth Glaser and her daughter Ariel
In March 2010, I and other Foundation colleagues attended a conference and symposium at the Harvard School of Public Health that was the basis for this new report
. It was framed around the concerns of women living with HIV before and during pregnancy, and explored issues raised by intended and unintended pregnancy.
The conference was one of the first to convene representatives from across disciplines and experience, with participants from diverse countries engaged in a range of HIV/AIDS and sexual and reproductive health work. Our work was also shaped by women living with HIV who courageously shared personal experiences of pregnancy and parenthood.
Speaking with women living with the virus at this conference and also at Foundation-supported sites always renews my commitment to ensure health services are available to meet their needs. These new research recommendations are designed to provide healthcare workers, program implementers, and policy makers with the information they need to allow women to make their own decisions about pregnancy and family planning.
At the conference, the most pressing needs identified were:
- Research at the individual women’s level, including addressing needs for contraception, parenthood, and individual mother’s and infant’s health
- Research at the health systems level, including the appropriateness of various service delivery models for quality services for women living with HIV
- Research at the community level, including the impact of stigma, discrimination and violence on a woman’s decision to have children
- Research at the legal and policy level, including the impacts of national laws and policies on access to information and health services for women living with HIV and their partners
The Foundation contributed to this agenda to continue our important work in advancing research and programs to prevent mother-to-child transmission of HIV.
I feel fortunate because so far, my son is healthy, and also I am able to continue working to support other women, including women living with HIV, to have healthy children. Our commitment to protecting children from HIV and AIDS begins with supporting women and men to have healthy families.
Elizabeth Flanagan is a Senior Technical Officer supporting HIV prevention and care and treatment programs, based in Washington, D.C.