Women who are HIV positive need more services and support to plan their pregnancies safely, an infectious disease specialist says.

A study of HIV-positive women in Ontario found 69 per cent said they would like to have a baby and 57 per cent said they actually intend to do so, researchers reported in Monday's online issue of the journal PloS One.

'These women can actually live lives that are equivalent in life expectancy to the general population.'— Dr. Mona Loutfy

The study results were based on a detailed questionnaire of 490 women from 38 sites across the province who completed a survey between October 2007 and April 2009.

For a long time, doctors discouraged HIV-positive women from getting pregnant because they feared the mother would die or would transmit the virus to the baby, said Dr. Mona Loutfy, an infectious disease specialist at Women's College Hospital in Toronto.

"Today is a very different time in the management of HIV," Loutfy said in an interview.

"We have excellent drugs to manage HIV, and if combinations of these drugs, three or more are taken, these women can actually live lives that are equivalent in life expectancy to the general population."

If the woman is treated during pregnancy, labour and delivery and doesn't breastfed, the chance of transmission can be reduced to less than one per cent, if not zero, Loutfy added.

The researchers found there was a lack of services and support for women who were HIV positive and wished to become pregnant. Shari Margolese, who is HIV positive, volunteers with Voices of Positive Women, an organization in Toronto that supports more than 900 HIV-positive women in Ontario.

Margolese said she told her son, who is now 17, about her HIV status when he was young to get him familiar with the terms HIV and AIDS.

"My advice to other women and families is, 'How does your family normally deal with sensitive information within the family?'" Margolese said.

"Because people have other pressures on them, possibly from their cultural background, they may be in a situation where in fact the stigmatization from HIV will affect their lives," unlike in her own situation, which Margolese said included the support of family and friends.

Results reflect African rates

The proportion of HIV-positive women living in Ontario who intended to become pregnant was similar to results of studies from African populations, rather than a previous survey from British Columbia that found only 30 per cent of HIV-positive women were interested.

Loutfy attributed the difference to the demographics of Ontario, which includes many immigrants from Africa and the Caribbean.

About 200 babies are born each year in Canada to HIV-positive women, said Dr. Deborah Money, executive director of the Women's Health Research Institute in British Columbia, and an expert in viral pathogens in women and pregnancy.

Fertility clinics are only starting to become comfortable in dealing with HIV-positive couples, Money said, but procedures such as artificial insemination are important for conceiving safely if only the woman is HIV positive.

For men who are HIV positive and wish to have children, some fertility clinics offer a technique to separate the sperm from fluid to reduce its infectiousness.

HIV-positive dads

The sperm preparation can cost between $200 and $400, said Dr. Matt Gysler, medical director of ISIS Regional Fertility in Mississauga, Ont.

Loutfy said she surveyed 23 of 28 clinics registered with the Canadian Fertility and Andrology Society and found about half were willing to see HIV-positive patients, but only six offered the sperm preparation technique.

Margolese and Loutfy travel across the province and Canada to share information and support. The pair are working on national guidelines on planning pregnancy for people who are HIV positive, which should be available in early 2010.

The study was funded by the Canadian Foundation for AIDS Research and the AIDS Bureau of Ontario's Ministry of Health and Long-Term Care.

With files from The Canadian Press