Just*in Time: September 2012 HIV and the Unborn

Just*in Time: September 2012

Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved

Hi Justin,
I found your site through a friend of mine who knows you personally, but I do not want to share his name. I’m a twenty-six-year-old HIV-positive female. Well, I just found out two days ago that I’m pregnant. I’m scared of transmitting HIV to my unborn child; what should I do? I haven’t been to see my regular doctor yet. Please help me. What should I do?—Andrea

Go see your doctor immediately. Listen, the faster you see a doctor the more that can be done about taking preventive measures to protect your unborn child. Okay, so here are some facts. Yes, a mother can pass on HIV to her unborn child but if precautions are taken this percentage is lowered to single digits. There are HIV medications that many women take during pregnancy. Also, when the child is born, doctors might suggest that he or she start on medications as well. When delivery time is near you could opt for a C-section or vaginal delivery, depending on the state of your health. During childbirth there are a lot of fluids between mother and baby, but the less fluid during the delivery the better. But the main thing is to see a doctor; they will run blood tests on you and be upfront about your HIV status so that they know to take the proper precautions to protect you and your unborn child. When your doctor runs all the blood tests, HIV will come up anyway, whether you tell them or not. Trust and believe that you will be fine. I am not your doctor and I cannot tell you if your child will be born HIV-positive or not but think positively—it’s beneficial to your state of mind and your baby. Just keep in mind that you are thinking for two. By the way, congratulations!   Justin,
My wife and I are HIV-positive and we feel that breastfeeding is a bonding moment for the mother and child. We are not going to breastfeed our baby, who is HIV-negative, because we are afraid that we would pass on HIV to our baby. But we have friends that beg to differ. I think they are more worried about bonding with their child than they are about the health of their own child. I want to ask you your opinion because I know they read your column. They have told us that their child is HIV-negative but continue to breastfeed him. What do you think they should do?—HIV Parents
Well, let me just say congrats on the baby and I’m so happy for you both. I hope your friends are reading this. They need to stop breastfeeding immediately or take proper precautions to lower the infection rate; just because their child is now HIV-negative it doesn’t mean that the child will not develop HIV later on through breastfeeding by the HIV-positive mother. Even though breastfeeding has been proven beneficial to both baby and mother it has a chance of HIV infection. Breast milk is filled with nutrients and antibodies that can protect the child against diseases, but it has never been proven that it protects against HIV. Also, as the baby grows and matures, so does breast milk to better adapt to the baby’s needs. The mother while breastfeeding has a lower rate of being diagnosed with certain diseases as well. These benefits are great but, being HIV-positive, one must take precautions. In this area of HIV transmission, breastfeeding, I’m afraid, must be avoided. But you can feed your baby in another way, by using commercial formula. In many parts of the world breastfeeding is the only option because of lack of finances and resources. One out of four children worldwide is infected with HIV through breastfeeding. I hope you’re listening.
Justin B. Terry-Smith has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.
September 2012

Justin’s HIV Journal: Justin & Phil Become Foster/Adoption Parents (Pozitive Parents)

Back in 2006 I was diagnosed with HIV and I cried about it at first.  People of course think when they are being diagnosed with HIV is that their first thought is that they are going to die, NOT I.  I very first thought that made me cry was that I wasn’t going to be able to have any children.  At the time I didn’t know about sperm cleansing at all.  I felt like I was damaged goods and I thought I would never have the feeling of being a good father.   With the feelings that came with my HIV diagnosis, also went the feelings that I would ever hear anyone call me Dad.   After my diagnosis the idea of being a father just went away because I didn’t feel like I could ever do it while being HIV positive.  Let’s break this down:

1)      After I did research I found out about Sperm Washing and how that would rid the sperm of HIV.  Sperm washing is a process which has been developed for couples who wish to have a child, where the male is HIV-positive and the female is HIV-negative. The procedure reduces the risk of HIV transmission to the female partner and subsequently the unborn child.  Sperm washing stands on the foundation that HIV infected material is carried primarily in the seminal fluid rather than in the sperm itself. The technique involves purifying sperm from seminal fluid. The sperm is then used for insemination into the female partner when she is ovulating and most likely to become pregnant (called Intra-Uterine Insemination or IUI), or for in vitro fertilization, (IVF).  A recent study found the risk of HIV transmission from sperm washing to be zero.  I thought oh my gay WOW this would be great, now all I have to do is find out where to go to do this. 

2)      Finding a female that would be willing to take the risk even after the sperm would be washed of all HIV.  There has not been a case where a female has been infected with HIV after sperm washing has taken place. 

3)      At the Gay Men’s Health Summit in 2012 I did some research about Artificial Insemination.  There was an organization that does the Sperm Cleansing and then fits you with a surrogate.  I thought, “Wow How exciting!!” Then I saw the price tag, and I said, “Well we can’t afford that right now”. 

Another option that occurred to us was to adopt.  Here is the thing with adoption; if you go through an agency it can take a lot of money and can seem costly also a lot of people have a moral issue with going through an agency.  Some people think that going through an agency is saying that there adoption is more like a financial deal than made out of love.  I don’t think that way, but some people do.  Because of the cost of adopting through an agency, Phil and I have decided to go through the state for Foster Care and Adoption. 

The state of Maryland has no provisions against same-sex married couples adopting children.  Also since I am HIV positive I had thought long and hard about this and I also wondered if that would be a reason for the state to reject us from being Foster/Adoptive Parents for the state of Maryland.  During Baltimore Pride Phil and I passed a stand at the festival that gave out information on Maryland State Foster Care/Adoption, so we took one.  Then we called the number on the pamphlet and made an appointment.  The appointment was to start classes in Anne Arundel County (Annapolis) for Foster Care/Adoption.  In the classes there are 24 hours of training that you must complete.  Phil and I had to go to Annapolis Maryland every Thursday from 5:30PM - 8:30PM which isn’t bad considering how important the classes are and what the end result might be.  We started our classes back in June and finished them.  We missed one classes but we were able to make it up.  

During the classes each household must have what are called, “Home Visits”.  A home visit is done by the state to inspect your home and to make sure that it is safe.  Depending on what age group you are looking to adopt there will be certain things that they will be looking for.  Phil and I opted to Foster or Adopt in the age group Infancy to 5 years old.  So there were stair gates, child car seats, a stroller, and other supplies that needed to by purchased.  When Fostering teens one of the things they look for is to make sure your alcohol is locked up or in a secure location in the home.    Since we have been a part of this program we have had 4 home visits thus far and that should be our final one.  Also there is another important thing you must know.  Home Visits are the only inspection your household must go through.  

The household has to be inspected by the fire department for safety reasons.  One reason is to make sure that you have smoke and carbon monoxide detectors in your house.  They will measure each room you have in your house.   The reason why they are measuring each room is to see how many children can live in your house at one time.  Our number for our house is 5 children.  Phil said, “Oh wow I can’t wait to tell our Social Worker that we can have 5 children”.  I then GASPED!!.  Phil was only kidding but 2 children are what we had originally planned for, but as you know sometimes things come up!!!  

You also have the option to care for a special needs child.  We made sure that it was known that we would take in a HIV positive child.  Also we needed to get our physician check up as well.  When you are HIV positive and trying to be a Foster or Adoption parent you MUST be undetectable.  Also you have to be cleared of other disease like TB.

 

People asked if we wanted a boy or a girl and other questions.  Well we are open to a boy or a girl, any religion, race, etc., it didn’t matter to us; we want to provide a good home to children who need it.  I had first bought up the subject of children to Phil before we got married.  I needed to know that he was on board with having children and low and behold he was and still is.  Having children is a big responsibility and making sure that I have time to spend with them is a must.  J