The #HIVLoveWins Story Shannon Weber, MSW Director, HIVE

The #HIVLoveWins Story Shannon Weber, MSW Director, HIVE

The #HIVLoveWins Story Shannon Weber, MSW Director, HIVE Founder & Director, PleasePrEPMe [email protected] vignettes October 2007. An HIV-positive man seeking to conceive with an HIVnegative partner called for information on local sperm washing and IVF programs. Provided information on national programs, as no such services were available locally. The couple ultimately traveled to another state for assisted reproduction services.

2008 change in CA law even more vignettes January 2008. An obstetrician with an HIV-negative female whose partner is HIV-positive called seeking IVF treatment for sero-discordant couples. Provided the local IVF and sperm washing information. February 2008. An HIV-positive male patient called because he and his HIV-negative partner wish to conceive. Provided them with the local sperm washing and IVF clinic information for sero-discordant couples. February 2008. An HIV-positive male patient called because he and his HIV-negative partner wish to conceive. Provided them with the local sperm washing and IVF clinic information for sero-discordant couples. February 2008. An HIV-positive male patient called because he and

his HIV-negative partner wish to conceive. Provided them with the local sperm washing and IVF clinic information for sero-discordant couples. February 2008. An HIV-positive male patient called because he and his HIV-negative partner wish to conceive. Provided them with the local sperm washing and IVF clinic information for sero-discordant couples. NY Reporter 2011 HIV Prevention Conference Contact: Shannon Weber 415.206.4241 [email protected]

Preventing HIV Transmission During Conception: Information and Referral for HIV Serodiscordant Couples Weber S1, Goldschmidt R1, Cohan D2 Introduc tion HIV-infected adults desire children. The risk of HIV transmission from unprotected intercourse can be reduced. The National Perinatal HIV Clinicians Network provides information and referral to clinicians and patients seeking conception. 1National

Results 94 total calls 57% of calls were from patients 43% of calls were from clinicians Call Volume by Year 30 25 Methods HIV/AIDS Clinicians Consultation Center; 2Department of Obstetrics, Gynecology and Reproductive Sciences San Francisco General Hospital, University of California San Francisco

Patients and clinicians desire access to clinically sound advice and referrals to reduce HIV transmission risk during conception. Perinatal HIV Clinicians' Network Serodiscordant Conception Call Topics N=94 Periconception risk reduction options other than assisted reproduction (including PrEP)

20% Legal queries 3% Providing this information and referrals meets the National AIDS Strategy goals of preventing new infections and increasing access to care. Assisted reproduction referral 77%

20 N Percent T he National Perinatal HIV Hotline and Clinic ians Network Male HIV+/Female HIV- 85

90.4% 888.448.8765 Female HIV+/Male HIV- 2 2.1% w w w.nc c c .uc sf.edu Male HIV+/Surrogacy

7 7.4% 94 100.0% Direction of Serodiscordance 15 Reviewed Perinatal HIV Clinicians 10

Network calls from 8/06 to 1/10. Analyzed calls about safer conception 5 options for discordant couples to 0 determine: 2006 2007 2008 2009 2010 oNumber of calls oDirection of serodiscordance Of the countless professionals I have talked to over the years, you

oQuestion topics have been the most helpful and supportive. Im thankful you have a network of knowledgeable people that can help us. -34 year old, HIV negative woman in a discordant relationship Conclusion Total Acknow ledgements The Perinatal HIV Hotline and Clinicians Network is based at the National HIV/AIDS Clinicians' Consultation Center at San Francisco General Hospital in the UCSF Department of Family and Community Medicine and supported by a grant from the Ryan White HIV/AIDS Program of the Health Resources and Services

Administration (HRSA) as part of the AIDS Education and Training Centers (AETCs), IAS 2012: Washington DC Results & Conclusions Number of Calls Serodiscordant couple calls by year 50 45 40 35 30

25 20 15 10 5 0 4 3 2 7 3 0

16 17 3 2 Patient Clinician 14

18 26 11 0 1 2 0 8

9 2006 2007 2008 9 Year 14

2009 18 2010 2011 p-value trend <0.001 National Perinatal HIV Hotline- Serodiscordant Couple Calls N=152 Call volume increased significantly over time 63% requested referrals for assisted reproduction 34% sought risk reduction options when assisted reproductive technologies were unavailable or unaffordable, including pre-exposure prophylaxis (PrEP) and timed intercourse A majority of the calls (83.6%) related to Direction HIV+ male/HIVfemale couples of Number of

discordance Male HIV+ Female HIVFemale HIV+ Male HIVMale HIV+ Surrogate Total calls Percentage 127 83.6%

14 9.2% 11 152 7.2% 100.0% The Perinatal HIV Hotline is an increasingly utilized resource on this topic. . Providing safer conception options to serodiscordant couples is a critical component of promoting the reproductive

rights of HIV-affected couples in the United States. The Universe is made of stories, not of atoms. Muriel Rukeyser Initiative launched by BAPAC at Ward 86 HIV clinic Aimed at the ~500 HIV+ men who have sex with women Supporting HIV+ mens sexual & reproductive health intentions Integrating sexual & reproductive health care into a primary care HIV- female partners can receive care at BAPAC

2012 PRO Men Focus Groups Identify common themes Gaps in knowledge Gaps in services Engaging patients Developed relationships for filming ++ Provider thought leader interviews PRO-Men Focus Groups: reproductive health knowledge, attitudes & desires How it is that you can tell your partners that you are HIV positive? And then make it possible so if you are in a relationship with a woman? And let her know I do want to be with you. How it is that you tell people?

I fear rejection the most. I would like a support group. Because all the men know how to get babies. And people with HIV know how to abstain from having sex. But if you have sex with a woman who doesnt have HIV and try to have a baby? We want information on what to do and how to do it. Because I still dont know how to do it. Changing from a story about giving permission to a place of possibility. #GlobalSHARE

Global Community for Sex, HIV and Reproductive Empowerment We support healthy sex lives and families. We are creating a global movement translating emerging science into action supporting every persons reproductive goals. Join the GlobalSHARE Google Group to share ideas, best practices, & challenging questions. All are welcome. To join, visit: www.hiveonline.org https://hiveonline.org/saferconceptionendorse/ Considering factors such as risk tolerance, personal health, costs,

and access to health care services, providers can help couples make the best decision for their personal circumstances. HIVE A Hub of Positive Reproductive & Sexual Health Founded in 1989 at Zuckerberg San Francisco General Hospital. Formerly Bay Area Perinatal AIDS Center (BAPAC). What do we do? HIVE Clinic: multidisciplinary preconception, prenatal, gynecologic and sexual health care to women living with HIV as well as HIV-affected couples.

HIVE Ward 86 Repro Health Clinic Guy Vandenberg, RN, MSW & Shannon Weber, MSW Patients or couples in serodifferent relationship. HIV-disclosure, transmission risk, prevention. Questions about family planning & HIV. Single parenting, co-parenting or surrogacy. Assessments, patienteducation and counseling, referrals to W86 PrEP Clinic. Refer your patients! [email protected] 415-206-2482 HIVEonline.org

Resources for providers Integrated resources on sexual & reproductive health Videos of how to counsel patients Sample order sheets Resources for patients Information sheets on prevention options in and around pregnancy (Spanish & English) Videos of patient experiences HIVE Blog

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