Lynn T Matthews1,2, Letitia Greener3,4, Hazar Khidir5, Christina Psaros6, Abigail Harrison7, F Nzwakie Mosery3, Mxolisi Mathenjwa3, Kasey O'Neil2, Cecilia Milford3, Steven A Safren8, David R Bangsberg9, Jennifer A Smit3. 1. University of Alabama at Birmingham, Birmingham, AL, United States of America. 2. Center for Global Health and Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States of America. 3. Department of Obstetrics and Gynaecology, MRU (MatCH), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa. 4. Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 5. Harvard Medical School, Massachusetts General Hospital, Brigham and Women's Hospital, Combined Residency Program in Emergency Medicine, Boston, MA, United States of America. 6. Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA, United States of America. 7. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America. 8. Department of Psychology, University of Miami, Coral Gables, FL, United States of America. 9. Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, United States of America.
Abstract
OBJECTIVE: Many men living with HIV want to have children. Opportunities to reduce periconception HIV transmission include antiretroviral therapy as prevention, pre-exposure prophylaxis, limiting condomless sex to peak fertility, and sperm processing. Whether men have knowledge of or want to adopt these strategies remains unknown. METHODS: We conducted focus group discussions (FGDs) with men accessing HIV care in South Africa in 2014 to inform a safer conception intervention for men. Eligible men were 25-45 years old, living with HIV, not yet accessing treatment, and wanting to have a child with an HIV-negative or unknown serostatus female partner (referred to as the "desired pregnancy partner"). FGDs explored motivations for having a healthy baby, feasibility of a clinic-based safer conception intervention, and acceptability of safer conception strategies. Data were analyzed using thematic analysis. RESULTS: Twelve participants from three FGDs had a median age of 37 (range 23-45) years, reported a median of 2 (range 1-4) sexual partners, and 1 (range 1-3) desired pregnancy partner(s). A third (N = 4) had disclosed HIV-serostatus to the pregnancy partner. Emergent themes included opportunities for and challenges to engaging men in safer conception services. Opportunities included enthusiasm for a clinic-based safer conception intervention and acceptance of some safer conception strategies. Challenges included poor understanding of safer conception strategies, unfamiliarity with risk reduction [versus "safe" (condoms) and "unsafe" (condomless) sex], mixed acceptability of safer conception strategies, and concerns about disclosing HIV-serostatus to a partner. CONCLUSIONS: Men living with HIV expressed interest in safer conception and willingness to attend clinic programs. Imprecise prevention counseling messages make it difficult for men to conceptualize risk reduction. Effective safer conception programs should embrace clear language, e.g. undetectable = untransmittable (U = U), and support multiple approaches to serostatus disclosure to pregnancy partners.
OBJECTIVE: Many men living with HIV want to have children. Opportunities to reduce periconception HIV transmission include antiretroviral therapy as prevention, pre-exposure prophylaxis, limiting condomless sex to peak fertility, and sperm processing. Whether men have knowledge of or want to adopt these strategies remains unknown. METHODS: We conducted focus group discussions (FGDs) with men accessing HIV care in South Africa in 2014 to inform a safer conception intervention for men. Eligible men were 25-45 years old, living with HIV, not yet accessing treatment, and wanting to have a child with an HIV-negative or unknown serostatus female partner (referred to as the "desired pregnancy partner"). FGDs explored motivations for having a healthy baby, feasibility of a clinic-based safer conception intervention, and acceptability of safer conception strategies. Data were analyzed using thematic analysis. RESULTS: Twelve participants from three FGDs had a median age of 37 (range 23-45) years, reported a median of 2 (range 1-4) sexual partners, and 1 (range 1-3) desired pregnancy partner(s). A third (N = 4) had disclosed HIV-serostatus to the pregnancy partner. Emergent themes included opportunities for and challenges to engaging men in safer conception services. Opportunities included enthusiasm for a clinic-based safer conception intervention and acceptance of some safer conception strategies. Challenges included poor understanding of safer conception strategies, unfamiliarity with risk reduction [versus "safe" (condoms) and "unsafe" (condomless) sex], mixed acceptability of safer conception strategies, and concerns about disclosing HIV-serostatus to a partner. CONCLUSIONS:Men living with HIV expressed interest in safer conception and willingness to attend clinic programs. Imprecise prevention counseling messages make it difficult for men to conceptualize risk reduction. Effective safer conception programs should embrace clear language, e.g. undetectable = untransmittable (U = U), and support multiple approaches to serostatus disclosure to pregnancy partners.
Authors: Sheree R Schwartz; Jean Bassett; Ian Sanne; Rebecca Phofa; Nompumelelo Yende; Annelies Van Rie Journal: AIDS Date: 2014-07 Impact factor: 4.177
Authors: Olga M Villar-Loubet; Laura Bruscantini; Molatelo Elisa Shikwane; Stephen Weiss; Karl Peltzer; Deborah L Jones Journal: Cult Health Sex Date: 2012-09-13
Authors: Alison J Rodger; Valentina Cambiano; Tina Bruun; Pietro Vernazza; Simon Collins; Jan van Lunzen; Giulio Maria Corbelli; Vicente Estrada; Anna Maria Geretti; Apostolos Beloukas; David Asboe; Pompeyo Viciana; Félix Gutiérrez; Bonaventura Clotet; Christian Pradier; Jan Gerstoft; Rainer Weber; Katarina Westling; Gilles Wandeler; Jan M Prins; Armin Rieger; Marcel Stoeckle; Tim Kümmerle; Teresa Bini; Adriana Ammassari; Richard Gilson; Ivanka Krznaric; Matti Ristola; Robert Zangerle; Pia Handberg; Antonio Antela; Sris Allan; Andrew N Phillips; Jens Lundgren Journal: JAMA Date: 2016-07-12 Impact factor: 56.272
Authors: William Kilembe; Kristin M Wall; Mammekwa Mokgoro; Annie Mwaanga; Elisabeth Dissen; Miriam Kamusoko; Hilda Phiri; Jean Sakulanda; Jonathan Davitte; Tarylee Reddy; Mark Brockman; Thumbi Ndung'u; Susan Allen Journal: BMC Public Health Date: 2015-07-02 Impact factor: 3.295
Authors: Lynn T Matthews; Cecilia Milford; Angela Kaida; Matthew J Ehrlich; Courtney Ng; Ross Greener; F N Mosery; Abigail Harrison; Christina Psaros; Steven A Safren; Francis Bajunirwe; Ira B Wilson; David R Bangsberg; Jennifer A Smit Journal: J Acquir Immune Defic Syndr Date: 2014-12-01 Impact factor: 3.731
Authors: Monique A Wyatt; Emily E Pisarski; Yolandie Kriel; Patricia M Smith; Mxolisi Mathenjwa; Manjeetha Jaggernath; Jennifer A Smit; Lynn T Matthews; Norma C Ware Journal: AIDS Behav Date: 2022-06-30
Authors: Lynn T Matthews; Christina Psaros; Mxolisi Mathenjwa; Nzwakie Mosery; Letitia Rambally Greener; Hazar Khidir; Jacquelyn R Hovey; Madeline C Pratt; Abigail Harrison; Kara Bennett; David R Bangsberg; Jennifer A Smit; Steven A Safren Journal: JMIR Form Res Date: 2022-05-04
Authors: Sarah A Gutin; Gary W Harper; Neo Moshashane; Kehumile Ramontshonyana; Rob Stephenson; Starley B Shade; Jane Harries; Okeoma Mmeje; Doreen Ramogola-Masire; Chelsea Morroni Journal: BMC Public Health Date: 2021-12-08 Impact factor: 4.135