Working with Women and AIDS: Medical, Social, and Counselling Issues

By Judy Bury; Val Morrison et al. | Go to book overview

5

Pregnancy and HIV

Screening, counselling and services

Mary Hepburn

INTRODUCTION

In Scotland more than half of those infected with HIV acquired their infection through injecting drug use; approximately one-third of these are women. Of concern for the future is the rising number of people infected heterosexually, of whom two-thirds are women (see Chapter 1). The majority of those infected with HIV are young, with women on average younger than men and those infected through drug use younger than those infected through other routes (Communicable Diseases (Scotland) Unit, 1991). Injecting drug use closely correlates with socio-economic deprivation and, since heterosexual spread in Scotland also usually has its origins in injecting drug use, many of those infected have a background of other social problems. The situation in Scotland clearly demonstrates that HIV infection has relevance for everyone, even though many will be unaware that they are at risk. It also demonstrates the major implications for women, for their own health, for their children’s health through the risk of vertical transmission, and consequently for their reproductive choices. In addition to coping with the possibility and actuality of HIV infection, many women will also have to deal with drug use or other problems due to socio-economic deprivation.

In my post as consultant obstetrician and gynaecologist I lead the team which provides the Glasgow Women’s Reproductive Health Service for women with social problems. Due to the correlation between injecting drug use and social deprivation we care for many women who use drugs or are partners of drug users and consequently women with HIV infection. Our service is multidisciplinary, with contributions from a wide range of professionals both medical and non-medical, and all members of our team are experienced in dealing with the issues involved. Care is delivered through community-based clinics where women can receive help with all their problems at the same time. They can reach the service by any route they choose, including self-referral, at any time they choose, with or without an

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Working with Women and AIDS: Medical, Social, and Counselling Issues
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Tables and Figures ix
  • Foreword xiii
  • Acknowledgements xv
  • Introduction 1
  • Part I - Background Issues 7
  • 1 - Women and the Aids Epidemic 9
  • 2 - Social Issues 23
  • 3 - Reflections on Women and Hiv/Aids in New York City and the United States 32
  • Part II - Contraception and Pregnancy 41
  • 4 - Pregnancy, Heterosexual Transmission and Contraception 43
  • 5 - Pregnancy and Hiv 58
  • References 68
  • Part III - Prostitution 69
  • 6 - Hiv and the Sex Industry 71
  • 7 - Developing a Service for Prostitutes in Glasgow 85
  • References 95
  • Part IV - Education and Counselling Issues 97
  • 8 - Education and the Prevention of Hiv Infection 99
  • 9 - Offering Safer Sex Counselling to Women from Drug-Using Communities 110
  • References 116
  • 10 - Women as Carers 117
  • Part V - Feelings and Needs 123
  • 11 - Feelings and Needs of Women Who Are Hiv Positive 125
  • 12 - Being Positive 135
  • 13 - Poems 142
  • Name Index 146
  • Subject Index 148
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