SE2 EP8 [Encore broadcast]: HIV, Fatherhood & Fertility
For many years, becoming a father was out of the question for many men living with HIV. But times have changed and condomless sex and parenthood are now realities, thanks to advances in treatment and the evidence-based, stigma-busting messaging around Undetectable=Untransmittable, or U=U.
Tune in to hear Dr. Mark Yudin from the University of Toronto, Logan Kennedy from Women’s College Hospital and Charlie talk about research on men’s fertility desires and fatherhood, stigma-free parenting environments and the reasons why fertility researchers are turning their attention to men.
Our episode guests
Dr. Mark Yudin
Professor at the University of Toronto and Staff Physician in the Department of Obstetrics and Gynecology at St. Michael's Hospital
Mark's clinical and research interests include general obstetrics and gynecology, colposcopy, and infectious diseases in women. He co-founded the Positive Pregnancy Program, a comprehensive and multidisciplinary program for the care of HIV-positive pregnant women, in 2006.
And to be able to say now to people, we can actually officially recommend that you have sex without a condom to get pregnant, just like every other couple who wants to get pregnant is, in my mind, a huge advance, both medically but also socially.
Registered Nurse, and Senior Research Associate and Implementation Lead at Women's College Hospital
Logan is a Senior Research Associate with the Women and HIV Research Program and Implementation Lead with the Canadian HIV Pregnancy Planning Guidelines Team at Women's College Hospital in Toronto. She has worked in the field of HIV and reproductive health in various clinical and research capacities since 2005. In addition to her work at Women's College Hospital, she is a full-time doctoral student in the Arthur Labatt Family School of Nursing at Western University.
…People are really excited to see that we're making this statement - that we can be counselling people and saying, have some sex and make a baby, if that works in your scenario or your relationship.
A person living with HIV who has experience interacting with healthcare professionals on issues concerning HIV, fatherhood and fertility.
...to know that you're undetectable, you're untransmittable, you can start a family, you can have healthy children, that is immensely empowering. Like, I can't express how empowering that is. It gives me opportunities that I thought were long lost and a chance at a life that I've always wanted.
Mark Yudin and Logan Kennedy have years of experience in reproductive health and highlight their desire to help people living with HIV achieve the family they want. While there is a lot of focus on women in this area, Mark and Logan point out that there are many men who want to have kids that require further information and support.
Research focusing on men's desires for fertility and fatherhood
Mark and Logan have led a cross-sectional study on the fertility desires and intentions of men, and wrote a paper titled, “An exploration of the fertility desires and intentions of men living with HIV in Ontario, Canada.” Dr. Yudin also co-authored another paper in 2021 exploring the importance of fatherhood among men living with HIV.
Mark speaks about the huge clinical change brought on by the science around Undetectable=Untransmittable (U=U) and claims he can now talk about condomless sex as a safe option.
To be able to say now to people, we can actually officially recommend that you have sex without a condom to get pregnant, just like every other couple who wants to get pregnant is, in my mind, a huge advance, both medically but also socially.
CATIE provides a number of informational documents about the science of U=U, including a practical guide on preventing HIV transmission. In another resource, CATIE provides an excellent introduction to the options available for people living with HIV who want to have children.
For further reading, check out:
- Canadian HIV Pregnancy Planning Guidelines
- A Clinical Practice Guide: What HIV care providers need to know about HIV pregnancy planning to optimize preconception care for their patients
Reigniting desires to become a dad
Later on in the episode James gets to talk with Charlie, who is HIV-positive and chose to remain anonymous for the interview. He worked as a Peer Researcher for the men’s fertility study that was led by Mark and Logan. He speaks about how inspiring it was to interview other men and hear their stories about their existing family, their desire for families, their children and step-kids, adoption and surrogacy.
He says that he felt his diagnosis took everything from him, including any thoughts about becoming a father. However, Charlie points out that learning the science behind U=U messaging and hearing participant stories reignited his desire to become a father, believing that becoming a good father is one of the greatest endeavours in life.
Charlie goes on to advise physicians not to underestimate the impact they can have on their patient’s life. He claims: “…when a man or a woman with a medical degree, and a white coat and a clipboard or whatever they're wearing looks you dead in the eye and smiles, and says you have plenty of options, and you can start a family and have healthy children, that is so powerful.”