Abstract

Background: HIV is a globally prevalent infection for which there is currently no cure or vaccine. As the number of individuals with HIV infection increases, so does the number of individuals wishing to have children despite being infected. This situation has highlighted issues related to couples where one partner is infected while the other is not (serodiscordant couples) and couples where both partners are positive. Major issues include pregnancy complications, transmission to the child, and potential side effects of the ART treatment on the health of the child. Women living with HIV who become pregnant or contract the virus during pregnancy are at risk for both maternal and perinatal morbidity and mortality, especially if the virus is not adequately controlled. Additionally, there is a risk of vertical transmission through breastfeeding during pregnancy and postpartum. To mitigate the consequences of HIV during pregnancy, it is ideal to start with prepregnancy counseling and plan pregnancies during periods of minimal viral load using appropriate methods.

Aims and Objective: There are limited studies and shared experiences regarding fertility status and issues of HIV/AIDS patients, especially in Turkey. Hence, this study aimed to investigate the fertility status of HIV/AIDS patients and their partners followed up in our clinic, shed light on the encountered issues, and share our experiences.

Methods: This retrospective, observational, single-center cross-sectional study included HIV/AIDS patients and their partners followed at Hatay Mustafa Kemal University (MKÜ) Medical Faculty Hospital from January 2018 to December 2023. Demographic data of the patients, their sexual orientations, HIV/AIDS status of their partners and children, treatments received, CD4 cell counts, and viral load data were retrospectively obtained from the automation system of our hospital and patient files.

Results: Among the couples, there were 21 pairs where both partners were HIV positive, 10 pairs where the woman was HIV positive and the man was seronegative (serodiscordant), and 5 pairs where the man was HIV positive and the woman was seronegative. In our study, eight couples with both partners HIV positive had nine children, and six couples with women who were HIV positive (serodiscordant) had ten children. The five couples with men who were HIV positive (serodiscordant) had six children. No vertical transmission was observed in our study, but three patients did not attend regular follow-ups. During the follow-up period, no seroconversion was detected in the partners of serodiscordant patients. The average gestational age was 38 weeks, and the average birth weight was 2873 ± 349 grams.

Conclusion: Our study found no vertical transmission and no seroconversion in partners of serodiscordant couples. Issues related to pregnancy in HIV-positive couples can be managed with pre-pregnancy counseling by specialists, protective methods, appropriate ART, and perinatal follow- up.

Keywords: HIV, pregnancy, serodiscordant couples, vertical transmission, antiretroviral therapy, cesarean section.