Pregnancy and the choices that people make in life about pregnancy can be complicated. In the case of children and young people who are HIV-positive, the choices about having a child may be conscious or unconscious, spoken or unspoken. There is research that suggests that those who lack emotional support and stability look to early sex and motherhood to provide closeness (Horwitz et al. 1991; Musick 1993). It has also been suggested that those with limited life options and choices are more likely to become pregnant (Coley and Chase-Lansdale 1998).
In one situation there was a teenager who was quite aware that she was gravely ill. She wanted to do everything in a short time frame. For her, getting pregnant was a way of strengthening the connection to her boyfriend. She had a child about a year and a half before she died. The baby was not infected.
Among the psychodynamics of teens having children is the perception that they may feel the need (conscious or unconscious) to leave a legacy, to live on in a healthy, HIV-negative child. For others who have lost family members to AIDS, the desire to have a baby can be seen as a way to begin to fill the void, to begin to have their family:
One teen talked about her sense of isolation. She had lost her mother, father, sister and grandmother to AIDS. She wanted to have a child to create a family as she had no remaining relatives.
In another situation the teen's HIV was behaviourally acquired but her mother was also HIV-positive. The role for unconscious motivation behind not protecting oneself during sexual activity when one is aware of HIV and lives in a home with someone who is HIV-positive must be thought about. This mother had a younger HIV-infected child. This teen had a healthy, HIV-negative child and was able to give her mother the gift of a 'healthy child' to live in her household.
The dynamics in HIV-positive families influence not only the HIV-positive youth's approach to sex but also other components of life. HIV-positive children who are perinatally infected may have apprehensions about having a child because they understand the experience of being born affected. On the one hand, there are the fantasies of having a child who would be just like you and whose life would emulate your own. On the other, there is the fear of having a child who will be HIV-positive as you have been and who will have to live with the associated demands.
In some ways, having a HIV-negative child in a family living with HIV can symbolize the 'undoing' of the illness in a way that no one who is HIV-positive can do, even by living longer on a lifetime of medications. Many teens and young adults want to be giving to their mothers. As they deal with issues of their own condition and feelings of inadequacy at being HIV-positive (and anger at the parent for transmission), they seek alternatives that allow them to feel they are 'escaping' or leaving it behind. There is a belief that they can in fact move away from HIV by having a healthy child. Currently perinatal transmission has been on the decline and nearly eliminated in the United States in those situations in which mothers have access to health care and the ability to adhere to retroviral regimens:
In another situation a young adult, in college and doing well, was someone no one thought would get pregnant but did. She saw herself as 'sick' and not like everyone else. For her, the idea of having a baby who was not sick made her feel more normal and less at the mercy of HIV
One teen described sex as the one area in her life where she was 'just like everyone else'. When her partners were unaware of her status and wanted to engage her in sex, she felt desirable. HIV made her feel 'ugly' and 'dirty'; when she was sexually attractive to another person those bad feelings went away.
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A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.