title: Engaging HIV care providers in conversations with their reproductive-age patients about fertility desires and intentions: a historical review of the HIV epidemic in the United States.
abstract: Provider-initiated conversations with people living with HIV about reproductive plans are lacking. Providers must know whether their patients want to bear children to tailor treatment and refer for HIV preconception counseling to help achieve patients' reproductive goals while minimizing transmission to partners and children. The early focus on men who have sex with men largely excluded consideration of the epidemic's impact on reproductive health. We used a historical review of the US epidemic to describe the problem's scope and understand if this legacy underlies the current neglect of reproductive planning. Drawing on peer-reviewed literature, we discuss key themes relevant to assessing and understanding attention to desires for children among HIV-positive people. We conclude with recommendations for addressing persistent stigma and enhancing patient-provider communication about reproductive intentions.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. rsteiner@jhsph.edu
authors.forename: Riley J
authors.initials: RJ
authors.lastname: Steiner
authors.forename: Sarah
authors.initials: S
authors.lastname: Finocchario-Kessler
authors.forename: Jacinda K
authors.initials: JK
authors.lastname: Dariotis
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D033182:Intention; D008297:Male; D009042:Motivation; D043762:Reproductive Behavior; D012747:Sexual Partners