Fatherhood and HIV

The ability to father a child is important for most men. In addition, for men diagnosed with HIV, achieving fatherhood can help in the re-negotiation of their masculine identities following diagnosis.

Men who are HIV positive and the partners of HIV positive women (regardless of their own HIV status) require support and information with regard to the best possible reproductive care. They also may need information and support about becoming a father and learning to care for an infant, especially an infant whose health will be carefully monitored over the first two years of his/her life. While health providers often acknowledge that men have an important role to play in providing social support and maintaining the health of their partner (for example through parent craft classes), men themselves often report feeling marginalised or of secondary importance. Men’s desires for fatherhood need to be acknowledged and their role during the reproductive process seen as more than conception related. More often, communication occurs through messages sent via the woman, with little direct engagement between men and reproductive healthcare professionals.

In preparing to care for couples expecting a baby who are affected by HIV there are additional opportunities to help health professionals to also directly engage with men such as in relation to:

• Disclosure and partner testing
• Discussion in relation to safer sexual practices and safer conception
• Once conception has been achieved, men may require support to cope with their own diagnosis and transition to fatherhood
• Men may require information tailored to them (or at least inclusive of them, acknowledging the father as a primary care-giver) on how to care for a new born infant, to manage questions around infant feeding, and to manage concerns about the health of the baby relating to HIV and beyond. Fathers may feel heightened health concerns for their babies which may be affected by HIV which could affect their early bonding with their child. Therefore, such fathers may need reassurance like mothers that they can learn to care for their baby.

Men may also require advice on how best to communicate with friends and family around the circumstances of the birth of their child. Men’s role in supporting their partners may also be of great value to them and their partners for example in relation to supporting their partner (where she is HIV positive) throughout the reproductive process in relation to:

• Encouraging attendance at appointments, access to services
• Adherence to treatment
• Decision making about delivery
• Feeding practices
• Psychological and emotional support
• Communication with friends and family

In this next video Adam describes how having a baby not only 'normalised' life but also increased his role as 'protector' of the family

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