With the life-extending benefits of HIV treatment, along with the effectiveness of ARVs used during pregnancy and delivery to prevent mother-to-child transmission (MTCT) of the HIV, childbearing among women living with the virus is widely considered to be a medical and ethical possibility. Yet little is known about the attitudes or MTCT knowledge among HIV-positive women of childbearing ages.

To explore this, Johns Hopkins researchers surveyed 181 HIV-positive women being treated at one of two Baltimore clinics. The average age of the participants was 32 years, with 26 percent younger than 30. About 94 percent were black. In addition, 65 percent already had at least one child, 65 percent had never been married, and 67 percent were on public assistance.

With respect to their views regarding childbearing, 68 percent said that it was acceptable for HIV-positive women to become pregnant. Eighty-five percent said that it was acceptable for HIV-positive women to adopt children. The greatest level of acceptance, the researchers reported, was among the youngest survey participants.

A higher percent of women, notably those younger than 30, desire to have-and plan to have, or continue having-a child. Among all survey participants, 48 percent desire a child and 44 percent plan to have a child. Among women younger than 30, 67 percent desire a child and either plan to have, or continue having, children. As for women older than 30, 36 percent desire a child and 28 percent plan to have, or continue having, children.

Sixty-seven percent of the women surveyed said they had discussed pregnancy and childbearing with their doctors. However, it was unclear from the report as to what percentage of these women were those who had already had a child-and thus received pregnancy care and counseling-since becoming infected with HIV. Many (64 percent), however, reported that they were the ones who initiated discussions with their health care providers.

The majority of women-62 percent-overestimated the risk of transmitting HIV during pregnancy and delivery. With proper care and ARV therapy that pushes viral load to undetectable, the risk of transmitting the virus is 1 to 2 percent. Women in the study, on average, thought the risk to be 18 percent.