Exploring Parenting Desires and Intentions of Young Black Gay Men Living with HIV Público

Abstract

The development of highly effective anti-retroviral drugs, the subsequent recognition of HIV as a chronic, manageable illness, and the development of advanced reproductive technologies all have potential significant implications on the parenting and fertility possibilities available to people living with HIV, as well as their parenting desires and intentions. The majority of fertility studies and resources for people living with HIV focus on heterosexual men and women, but recent studies have indicated that gay, bisexual and other men who have sex with men (GBMSM) living with HIV, and especially Black GBMSM living with HIV, also desire to have children. This paper describes the findings of a qualitative study conducted in Atlanta, GA, U.S.A that aimed to explore parenting desires and intentions of young Black GBMSM living with HIV, capture their perspectives regarding parenthood, and understand the unique challenges Black GBMSM living with HIV face in their fertility-decision making. In-depth interviews were conducted with fifteen Black GBMSM living with HIV aged 18-29 years. Participants reported varying degrees of desire to have children, and cited a variety of factors that influence their parenting and fertility decision-making, such as desire to pass on their legacy to children, and give more meaning to life, as well as their own health and level of preparedness. HIV status and sexual orientation were noted as complicating physiological factors to having biological children, and societal stigma and negative perceptions of Black gay fathers were discussed, however these were not perceived as deterrents to having children for those who were motivated to do so. Several recommendations were made for HIV care providers and clinics, including increasing access to information on childbearing options for GBMSM living with HIV and providing opportunities for education and peer support for Black GBMSM living with HIV. These findings point to a need for safer conception guidelines for this population, increased HIV care provider involvement in fertility and reproductive care, as well as additional research on policies and systems that make it challenging for Black GBMSM living with HIV to pursue and fulfill their parenting desires and exercise their reproductive rights. 

Table of Contents

Table of Contents 

LIST OF ABBREVIATIONS....................................................................................................................................... I 

CHAPTER 1: INTRODUCTION ............................................................................................................................... 2 

CHAPTER 2: LITERATURE REVIEW ................................................................................................................... 3 

FERTILITY DESIRES AND HETEROSEXUAL WOMEN, MEN, AND COUPLES AFFECTED BY HIV ................................... 4 

REPRODUCTIVE RIGHTS AND RESOURCES FOR PLH .................................................................................................. 6 

FERTILITY DESIRES, GBMSM, AND HIV ................................................................................................................... 8 

CULTURAL DIFFERENCES IN FERTILITY DESIRES ..................................................................................................... 10 

CHAPTER 3: METHODS ........................................................................................................................................ 14 

DEVELOPMENT OF RESEARCH TOOLS ...................................................................................................................... 14 

Screening questions ............................................................................................................................................ 14 

Semi-Structured In-Depth Interview Guide ........................................................................................................ 15 

SCREENING AND RECRUITMENT ............................................................................................................................... 16 

REFLEXIVITY ............................................................................................................................................................ 16 

ANALYSIS................................................................................................................................................................. 17 

CHAPTER 4: RESULTS ........................................................................................................................................... 19 

INFLUENCES ON CHILDBEARING ............................................................................................................................... 20 

Motivating Factors ............................................................................................................................................. 20 

Barriers to childbearing ..................................................................................................................................... 22 

HIV AND HEALTH IMPACT ....................................................................................................................................... 24 

STRATEGIES ............................................................................................................................................................. 27 

SOCIETAL PERCEPTIONS ........................................................................................................................................... 29 

READINESS ............................................................................................................................................................... 31 

Financial security ............................................................................................................................................... 32 

Physical and mental health ................................................................................................................................ 33 

Emotional maturity and relationships ................................................................................................................ 34 

RECOMMENDATIONS ................................................................................................................................................ 35 

FERTILITY DESIRES AND INTENTIONS OF YB-GBMSM LIVING WITH HIV COMPARED TO OTHER PLH ................. 38 

LIMITATIONS ............................................................................................................................................................ 43 

IMPLICATIONS .......................................................................................................................................................... 43 

CHAPTER 6: CONCLUSION .................................................................................................................................. 48 

TABLES ...................................................................................................................................................................... 49 

TABLE I: ILLUSTRATIVE QUOTATIONS ..................................................................................................................... 49 

REFERENCES ........................................................................................................................................................... 52 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	bisexual childbearing gay father HIV Black Black men gay Black fathers fertility desires family qualitative GBMSM reproductive rights procreative consciousness surrogacy parenting fatherhood safer conception MSM
Committee Chair / Thesis Advisor	Sophia Hussen, Emory University

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