Improvements in HIV treatment and prevention of mother-to-child transmission have opened the door to pregnancy for many HIV-positive women, a new study confirms. Among 490 HIV-positive women ages 18-52 recruited from 38 Ontario sites during October 2007 to April 2009, 69 percent reported a desire to become pregnant, including 57 percent who said they intend to do so.

"When I was seeing my patients, a lot of them were saying that they were interested in pregnancy," said lead author Dr. Mona Loutfy, an infectious-disease specialist at Women's College Hospital in Toronto. "They weren't being supported either by their family doctors or other doctors, or by the system, including fertility clinics."

"If a woman's HIV-positive, we can give her [antiretrovirals] and ask her not to breastfeed, and the baby has a less than 1 percent chance of getting infected with HIV," Loutfy said.

Most of the women surveyed were foreign-born, and 47 percent were of African ethnicity.

HIV-positive women intending to give birth may face stigma, including from family or friends who are not aware of HIV treatment and prevention developments, said Dr. Deborah Money, executive director of the Women's Health Research Institute in British Columbia. And members of the medical community may not respond positively, give accurate advice, or make an appropriate referral, she said.

If a woman is HIV-positive, she can be impregnated through traditional artificial insemination, Loutfy said. If a man is infected, he can bring down his viral count with drug therapy, and his sperm can be "washed" of HIV in a special laboratory technique that reduces the chance of infection, said Dr. Matt Gysler, medical director of the ISIS Regional Fertility Center in Ontario. That can cost $200-$400 (US $189-$377).

The full report, "Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study," was published in Public Library of Science ONE (2009;4(12):e7925).