written on 04.04.2016
HIV infection does not prevent the desire to have children! (© Subbotina Anna – fotolia) HIV is still a stigma that does not stop at family planning. Many affected women are unsure whether they should fulfill their desire to have children. Can an HIV-positive pregnant woman give birth to a healthy child? Jameda wanted to know this from Ms. Sonnenberg-Schwan, who is a member of the National AIDS Advisory Board, a psychologist at the Munich Women’s Health Center and a member of the advisory board of the non-profit foundation Sexualität und Gesundheit.
jameda: Who is most affected by HIV??
Ms. Sonnenberg-Schwan: About three quarters of those affected are men who have sex with men, 14 percent are women and about 5 percent are men who have contracted sex with women. 11 percent used drugs intravenously.
jameda: It is generally recommended that pregnant women have an HIV test, which is usually free of charge. But if the test is positive, the shock is great. How do sufferers best deal with the diagnosis??
Ms. Sonnenberg-Schwan: Many women don’t know what it is means, To be HIV positive and have very wrong ideas in mind. It is therefore important that they get as much information as possible. The best thing to do is to see a doctor with a focus on “HIV” to seek advice. There are also specialized counseling centers that patients can contact and films on the Internet. Incidentally, the father-to-be should be included and also have an HIV test done.
jameda: If HIV-positive women take all necessary measures, e.g. For example, if the child is examined regularly and taken certain medications, the child is not 99% likely to be infected with HIV. Why are there still doctors who advise abortion??
Ms. Sonnenberg-Schwan: Because they don’t know the guidelines. Fortunately, there are now very few gynecologists who think that HIV is a reason to stop pregnancy.
jameda: If both partners are HIV positive, they can fulfill their desire to have children in the normal way. If only the woman is affected, artificial insemination will help?
Ms. Sonnenberg-Schwan: In the past, artificial insemination was advised, but today most couples conceive their child naturally. Because if the woman takes medication at an early stage, the immune system is strengthened and the viral load decreases, so that no viruses are finally detectable in the blood. Then it hides intercourse hardly any risks. If a low risk is too high, you can undertake self-insemination and insert the sperm into the vagina, for example, on an upside-down condom.
jameda: When is insemination appropriate at the doctor??
Ms. Sonnenberg-Schwan: In the past, insemination was the method of choice when the man was HIV positive. Today, however, it is rarely used because the man is no longer infectious when HIV therapy works well and viruses can no longer be detected in the blood. IVF or ICSI are more likely to be used for fertility problems. Health insurance companies usually cover 50 percent of the costs – just like with other couples. However, a few reproductive doctors refuse treatment because they are wrong to fear complications.
Ms. Sonnenberg-Schwan is committed to HIV-positive women who want to have children (© Sonnenberg-Schwan) jameda: Do the medicines that the expectant mother has to take have a negative impact on the child?
Ms. Sonnenberg-Schwan: You can’t say with 100 percent certainty that the drugs are harmless, but there is no evidence that the affected children are more likely to develop malformations. Some newborns’ blood counts may have changed, but will go away on their own. However, the observation periods are still too short to completely rule out complications in advanced age. The first children who were born on this path are around 20 years old today.
jameda: Pregnancy does not adversely affect the mother’s course of the disease. What about the psychological stress of the expectant mother?
Ms. Sonnenberg-Schwan: After the first shock, many HIV-positive mothers come to life with pregnancy. It gives them support and a new perspective on life. Compared to other pregnant women, they have many additional Questions in mind and need more support. For many, the greatest burden is the possible rejection by the environment. Affected people should think carefully about whom to tell about their illness.
jameda: Should give birth to HIV-positive women by caesarean section or vaginal delivery?
Ms. Sonnenberg-Schwan: In the past, women were advised to have a caesarean section; today vaginal delivery is the norm. If the HIV therapy is successful and there are no viruses in the blood, the infection of the child is extremely rare. A caesarean section is only recommended if pregnancy complications arise or if viruses are still detectable in the blood. This may be the case if the woman started treatment too late.
jameda: After birth, the newborn must be treated with medication for two to four weeks. What side effects can these drugs have??
Ms. Sonnenberg-Schwan: The drugs are usually well tolerated and have no long-term side effects.
jameda: Why do HIV-positive women have to give up breastfeeding??
Ms. Sonnenberg-Schwan: If the viral load is below the detection limit, breast milk should be free of viruses. This can be different with breast infections. It is also not clear how many traces of the medication are excreted in breast milk. Therefore, it is better to switch to replacement food. Even a child who is not breastfed develops a healthy immune system!
jameda: HIV-positive mothers have to consider something specific in their everyday life with their baby?
Ms. Sonnenberg-Schwan: At first, the child has to go to the doctor more often to have HIV tests done. After four weeks you can tell whether the child is infected or not. Infection is not possible in everyday life. Mothers are well advised to bring as much normalcy as possible into their lives and not to withdraw. They are not obliged to inform crèches or kindergartens about their illness and, like other mothers, can also take part in retraining courses or baby swimming courses.
jameda: HIV-positive people now have an almost normal life expectancy thanks to improved therapies. Nevertheless, some are afraid that they will not be able to raise their child. To what extent this situation also affects children and partners?
Ms. Sonnenberg-Schwan: It is good to think about where to find support in the event of illness. It is difficult to say whether such thoughts burden family life. It depends on the family. The biggest challenge is probably the discrimination that HIV-positive people still often experience. When friends break contact, the job is at risk, or doctors refuse treatment, it can be very hurtful. Many women say that they can live well with the tablets, but discrimination is a major drawback.
jameda: Thank you for the interview!
This article is for general information only, not self-diagnosis and is not a substitute for a doctor’s visit. It reflects the opinion of the author and not necessarily that of jameda GmbH.
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