The #HIVLoveWins Story Shannon Weber, MSW Director, HIVE Founder & Director, PleasePrEPMe Shannon.weber@ucsf.edu

vignettes October 2007. An HIV-positive man seeking to conceive with an HIV-negative 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.

NY Reporter

2011 HIV Prevention Conference

IAS 2012: Washington DC

Direction of discordance Results & Conclusions 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 HIV+ male/HIV- female couples Direction of discordance Number of calls Percentage Male HIV+ Female HIV- 127 83.6% Female HIV+ Male HIV- 14 9.2% Surrogate 11 7.2% Total 152 100.0% 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+ men’s 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 doesn’t have HIV and try to have a baby? We want information on what to do and how to do it. Because I still don’t know how to do it. “

Changing from a story about giving permission to a place of possibility. Normalize the experience of the men. Normalize the clinician providing services. Engaged the general public and change stigma.

Making a video of a topic that is not often discussed so it takes research and time to explain to a patient. Crafting the script

Global Community for Sex, HIV and Reproductive Empowerment #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 person’s 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). Since 1989, HIVE has been at the forefront of innovating comprehensive HIV-informed sexual and reproductive health. Our mission is: Advancing reproductive and sexual wellness for individuals, families and communities affected by HIV in San Francisco and beyond. Our vision is: A world where people affected by HIV have safe pregnancies, reproductive autonomy, access to state-of-the-art health care, and enjoyable sex lives.

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. Based at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), HIVE Clinic provides multidisciplinary preconception, prenatal, gynecologic and sexual health care to women living with HIV as well as HIV­-affected couples. Our clinical care services include: Outpatient/inpatient high-risk obstetrics, obstetric-specific psychiatric care, genetic counseling/testing, prenatal nutrition & health education, inpatient nursery care, HIV testing & linkage to care for partners, children and other family members. Our social services include: Intensive medical case management, counseling, and social services for clients & families. HIVE Clinic is housed within the 5M Women’s Health Center at ZSFG – please come by and say hi anytime! Our physician Monica Hahn and our social worker Becca Schwartz see HIVE patients and their families in the primary care setting 6 weeks postpartum, so it’s really a beautiful continuum of care.

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, patient-education and counseling, referrals to W86 PrEP Clinic. Refer your patients! Guy.Vandenberg@ucsf.edu 415-206-2482 HIVE also offers a reproductive health clinic in partnership with Ward 86 and Guy Vandenberg! The clinic takes place on the second Friday of every month at Ward 86. This is an initiative of HIVE’s PRO Men (Positive Reproductive Outcomes for Men Living with HIV) project, which is core to our belief that all individuals should be asked about their reproductive intentions and desires, including men. At the Ward 86 Repro Health Clinic, patients or couples in a serodifferent relationship are able to meet with Guy and Shannon to talk about HIV disclosure, transmission risk, prevention, family planning in the setting of HIV, and safer conception. Guy’s contact info is there if you ever need to make a referral.

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 Using HIVE Clinic as our learning laboratory, HIVE program creates tools and resources for clinicians to provide highest quality care and to support consumers in achieving fulfilling sexual and reproductive lives. Through our website we are able to rapidly diffuse ideas and resources, and engage the online community. I encourage you to spend a few minutes perusing all our website has to offer. You will find awesome tools for you as a provider and your English and Spanish-speaking patients.

Here are just a few examples.

HIVE Blog HIVE blog highlights stories and voices of people living with HIV, women who use PrEP to conceive or for sex, trans people, and innovative collaborators. Here are a few of our most recent blogs. By providing space for stories to be shared, we can begin to break down HIV stigma and create a world where HIV is not a barrier to sexual wellness or safe pregnancies.