Medical Training for Health

More and more couples are HIV positive manifest the desire to have a baby. But they are not sufficiently informed about their illness and the possibility of giving birth to healthy children.

To promote informed choice Anlaids Lazio and National Institute of Infectious Diseases Lazzaro Spallanzani launched a counseling service for couples who are HIV positive and not conflicting, ie where one or both partners found to be infected by the virus. “Project parenthood, announced on 12 November in the press conference, is the first of its kind in Italy and could be replicated in other regions.

“The main problem of HIV-positive women is not therapy or who are following their survival,” says Ferdinando Aiuti, Commission President for health policy of the City of Rome. “What the main concern is whether they can have a healthy child . Or, if man is to be HIV positive, if they can become pregnant without becoming infected. ” The project, undertaken with the assistance of the Ministry of Equal Opportunity and the City of Rome, will help answer these questions and to plan the path to become future parents.

In 36 months at least 50 couples living with HIV receiving treatment at the clinical sites of the Lazio Region will be assisted in pre-conception, pregnancy and post partum from various professionals (psychologists, volunteers, infectious disease, gynecologists and pediatricians). Beyond. After birth the child will be assisted by pediatric center through adolescence.

Initiative, in fact, created to ensure the right of people to become HIV-positive parents and the child to be born healthy. Infection with HIV now affects a growing number of women of childbearing age, whose desire for parenthood and sanctioned by scientific advances. National surveillance data on the treatment antiretrovitrale pregnant, coordinated by the Istituto Superiore di Sanita (ISS) since 2001, show a good risk-benefit ratio of antiretroviral treatment in pregnancy. Thanks to treatment in women of childbearing age the danger is lowered to the point that in 2007 in Italy there was only one case of vertical transmission of HIV. Without treatment the frequency varies between 7 and 40 per cent. In the case of discordant couples where the man who is HIV positive has been shown that treating sperm you can remove the cellular component most infected by the virus, so an intrauterine insemination program would greatly reduce the risk of vertical transmission of ‘ HIV.

But although this possibility exists, the couples are still uninformed and lacks a serious plan the pregnancy. In 50 percent of cases, women with HIV, in fact, have not planned and 23 percent found the infection only during prenatal screening. In contrast, among those who know their HIV status, about half are already being treated at the time of conception, but 20 percent use a contraindicated therapy or at risk toxicity to the unborn child.

Hence the need for more widespread application of preconception counseling and HIV testing among women of childbearing age, a complete coverage for screening in pregnancy and appropriate assistance to couples. “The use of antiretroviral therapy in the nine months of gestation, Caesarean section and bottle-feeding contributed to the reduction of maternal fetal transmission of the virus,” says Giuseppe Ippolito, Scientific Director, INMA L. Spallanzani. “The identification of problems and concerns about the path to becoming parents and information on strategies to reduce maternal-fetal transmission of the virus are of primary importance for a pregnant HIV-positive for both couples discordant. Provide them support preconception counseling helps the couple to make a more informed choice. ”

Concluded the project will be a guide as a tool for disseminating information on adoption and access to care pathways for couples wishing to have a child in which one or both partners are HIV positive

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