How are men living with HIV counseled on reproductive health?

When it comes to HIV prevention and reproductive health within male/female couples, women often carry a disproportionate burden despite evidence that involving both partners can produce positive outcomes. One reason for that imbalance is our health care system’s tendency to exclude men from relevant discussions and decisions—both intentionally and unintentionally. A new study of providers caring for men living with HIV highlights the many opportunities missed to engage those men in conversations about contraception and fertility.

The study, which surveyed providers caring for HIV-positive men with female and/or male partners, found about 90 percent believe HIV-positive men should be asked about both fertility desires and contraception. However, only 5.7 percent and 55 percent of the providers had asked all of their own patients at least once about fertility and contraception respectively.

Barriers to communication between these HIV providers and their patients about reproductive health included a lack of time, assumptions about patients’ sexual practices and reproductive goals, and a lack of training in both contraception and safer conception methods for HIV-affected couples. Only half of respondents had ever received training in contraceptive care and few presented the full range of safer conception options.

By improving providers’ training and, in turn, increasing the knowledge and engagement of their male patients, more couples can truly share in decision-making regarding contraception and fertility.