BY Benjamin Ryan

December 16 2009 11:00 AM ET

The Times, They Are A-Changin’

For the first decade or so of the AIDS epidemic, the prospect of parenthood was fairly bleak for HIVers. Not only were their own life expectancies short, but an HIV-positive woman’s chance of infecting her baby with the virus was as high as 25% to 40%. In 1991 the number of infants born with HIV in the United States peaked at almost 2,000. Then, thanks to dramatic improvements in prevention protocol as well as vastly improved anti-HIV therapies, that figure took a nosedive.

Today, of the estimated 120,000 to 160,000 women living with HIV in the United States, according to the Centers for Disease Control and Prevention, about 6,000 to 7,000 give birth each year. The great news is that annually only about 150 of the newborns are infected with HIV, and that figure continues to drop. According to specialists at St. Vincent’s Comprehensive HIV Center in New York City, optimal medical care can reduce the chance of mother-to-child transmission to less than 1%. That’s backed up by a study reported in the May 11, 2008, issue of the journal AIDS. In the study researchers analyzed medical data from more than 5,100 pregnant HIV-positive women in the United Kingdom and Ireland and found that by 2005 the rate of mother-to-child transmission was just 0.8% due to successful prenatal HIV antibody testing and treatment of women found to be HIV-positive.

“We’ve changed from hopelessness to hope,” says Evelyn Harrington, a social worker at St. Vincent's who’s been working with HIVers since the inception of the epidemic.

Boosting that shift in mind-set, an Ohio State University study published in the journal AIDS and Behavior in early 2008 found that a quarter of HIV-positive women have hopes for motherhood. And the women who were younger than 30 when they tested positive were almost four times more likely than older women to say they wanted to become pregnant.

“We shouldn’t assume that women aren’t going to become pregnant -- or don’t want to become pregnant -- now that they have HIV. That’s an erroneous assumption,” says study coauthor Julianne Serovich, professor and chair of human development and family science at Ohio State. “Clinicians should be routinely discussing pregnancy with HIV-positive women of childbearing age.”











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