Poppy's Story - How A Magnetic Straight Couple Utilized PrEP for Conception

"When it came time to announce our pregnancy, we decided that we just wanted to come forward and tell the truth. We felt it was such a miracle that we were even pregnant that this child, and this process, deserved our honesty. So we told everybody. I took Truvada for a year and a half - and it worked."

A year and a half ago, My PrEP Experience featured a story from an HIV-negative woman, who we will call "Poppy", married to an HIV-positive man. The sero-discordant (magnetic) couple wanted to have a baby, and after a journey investigating various options that lasted more than a decade, Poppy chose to take Truvada as PrEP, to protect her from contracting HIV while still allowing her to conceive.

And guess what?

She stayed HIV-negative and got pregnant. Check out those toes up left - and that cute little mug to the right - to see the result of that pregnancy.

In this recording, Poppy tells her very compelling PrEP experience - from the beginning to a beautiful baby daughter, with features and characteristics from both her parents. Please take a few minutes to listen.

The recording is actually an excerpt from a webinar conducted on October 28, 2013 called "PrEP-ception: Sero-discordant couples using PrEP to reduce HIV transmission risk during pregnancy."

This webinar, the second in a series of webinars by the US Women and PrEP Working Group, discussed the possibilities and challenges associated with serodiscordant couples using PrEP to help them achieve pregnancy safely. In addition to a Q&A period, the webinar consisted of the following:

• Introduction: Overview of PrEP and the Role of the Working Group
  Dazon Dixon Diallo, MPH, Founder and President, SisterLove, Inc. 
• Defining the Need for Safer Conception Options: The Role of “PrEP-ception”
  Shannon Weber, MSW, Director, Special Projects, National HIV/AIDS Clinicians' Consultation Center, Bay Area Perinatal AIDS Center Coordinator
• A Framework for the Integration of PrEP
  Erika Aaron, CRN, Drexel University College of Medicine, Division of Infectious Diseases and HIV Medicine
• One Mom's Story
  Poppy

Click here for presentation slides, an audio link, and more information.

Click here for Poppy's recording.

[AUDIO] Magnetic Love and Making Healthy Babies - Carolina's story

This interview was conducted in Spanish. The Spanish transcription follows the English translation below. Click here for the audio link (in Spanish) and have a listen.

Folks interested in more English/Spanish PrEP and PrEPception information are invited to visit the PRO Men page of the BAPAC website.


Dr. Pollock: Hi, my name is Dr. Lealah Pollock.  I am a family medicine physician in the Family Health Center at San Francisco General Hospital.  Today, September 10th, 2014 we are at BAPAC’s offices at the San Francisco General Hospital with Carolina and her baby to talk about her experience using PrEP as part of her comprehensive care. At the San Francisco General Hospital we offer PrEP as part of primary care, comprehensive sexual health care.  So, hello Carolina.  How are you?

Carolina:  Very well Dr. Pollock.

Dr. Pollock: So, to commence. How did you get in touch with the Family Health Center and with BAPAC?

Carolina: I was receiving care at the Castro Mission clinic and asked my physician that I wanted to have a baby.  They gave me information about BAPAC and the San Francisco General Hospital. That is how I came here to the hospital to request information.  Well, they call me to give me information about PrEP and referred me to the Blue Team (primary care clinic) at the San Francisco General Hospital and I met the staff that helped me, especially you Dr. Pollock, they gave me guidance and more information on how to get pregnant from an HIV positive person.

Dr. Pollock: Very well.  And when you told your doctor. Was it the first time that you and your husband asked about getting pregnant?

Carolina:  No.  I had already asked my doctor at the clinic I used to go to, but they always told me that getting pregnant was impossible. It was here where I found the right answer.  You helped me to have that answer.

Dr. Pollock: Had you looked for information before that?

Carolina:  Yes.  I looked for a lot of information and it was always impossible.  They told me that the only way to get pregnant was insemination and that they had to “clean” my husband’s semen.  But we did not want that.  We wanted to get pregnant in a natural way.  It was impossible.  Thanks God that I was given the information here and here you have the results. 

Dr. Pollock: Good! How did you decide to take PrEP? I remember the first time I met you; your husband’s viral load was still detectable.  He did not have an undetectable viral load, and we took some time to talk about PrEP as a possibility.  So. Why did you in the end decide to take PrEP

Carolina:  I decided to take PrEP because the physicians in this hospital helped my husband’s viral load to become undetectable, so I felt more comfortable.  Unfortunately, there are not many women that have the possibility to have all of the information about PrEP, but I feel that in this hospital you have the best physicians that provide the necessary information and that is why I made the decision and thanks God all worked out well. 

Dr. Pollock: And thank you, but you were the one that had the strength of asking for information and make the decision of taking PrEP, and having a baby.  And the baby is so beautiful…

Carolina: …healthy…

Dr. Pollock: Did you have any adverse events taking Truvada or PrEP?

Carolina:  No, I did not have any adverse event.  I think that women should use it as a method.  We never know, many people do not want to ask, and yes, you can get pregnant and it is safe.  I did not have anything and I am very happy and prepared to have another baby.

Dr. Pollock: Good, in the future.  How was the experience with your husband and in your world that knew you were taking PrEP?

Carolina:  Well, personally, my life is my life and I make my own decisions and nobody in my family except my husband’s mother, father and few brothers know that he has this disease.  It is unnecessary that all of your family know about it if you do not want to.  You can make your own decisions, who you share it with.  And here, you know that this information is confidential.

Dr. Pollock: True.  Did your husband support you to take PrEP?

Carolina:  Yes, he supported me since both of us wanted to have a baby.  We dreamed with having a baby…and there she is!

Dr. Pollock: Do you have any piece of advice for other women that are planning on taking PrEP or having a baby with an HIV positive partner?

Carolina:  Yes, as far as they have health providers that are knowledgeable about it and that can provide them with the necessary information.  My advice is that if you can make your own decisions and find a specialist like the ones I have here at the San Francisco General Hospital.

Dr. Pollock: Very well. Thank you to talk to us today and share your experience.

Carolina:  Thank you for giving me this information and thanks to the General Hospital because we got what we wanted and without your support it might have not been possible to have this baby that we have today, six months old with adequate weight and healthy.

Click to the next page to read this interview in Spanish. Click here to listen to it.

Audio.

Dra. Pollock: Hola, me llamo Dra. Lealah Pollock.  Soy una doctora de medicina familiar en el Centro de Salud Familiar en el Hospital de General de San Francisco.  Estamos aquí el 10 de setiembre 2014 en la oficina de BAPAC en el Hospital General de San Francisco.  Estoy aquí con Carolina y con su bebé para hablar de su experiencia tomando PrEP como parte de su cuidado anticon…, pre-conceptivo, hem, y aqui en el Hospital General de San Francisco ofrecemos PrEP y cuidados de salud reproductiva comprensiva [integral] como parte de cuidados primarios, parte de salud general.  Entonces, hola Carolina ¿cómo estás?

Carolina:  Muy bien, Dra. Pollock. 

Dra. Pollock: Entonces, para empezar ¿cómo te conectaste con el Centro de Salud Familiar y con BAPAC?

Carolina: Yo estaba en tratamiento con mi clínica en Castro Mission y yo le comente a mi doctora que yo pues quería tener un bebé, y ellos me, ah, me dieron información sobre BAPAC en el Hospital General de San Francisco, y fue por eso que yo vine aquí a este hospital a pedir información.  Bueno ellos me llamaron a mi para poder, para, para, para darme la información sobre la PrEP, y, este, fue, cuando ellos me mandaron a Blue Team (cuidados primarios) de San Francisco, general, del Hospital General y fue cuando conocí a este personal que me ayudaron a usted Dra. Pollock, en especial, y este, fueron los que me guiaron y me dieron más información sobre poder yo quedar embarazada  con una persona de HIV positivo.

Dra. Pollock: Muy bien. ¿Y cuando le mencionaste a tu doctora, ahi, fue la primera vez que tú y tu esposo habían preguntado si pudieron quedarse embarazados?

Carolina:  No, yo ya había preguntado en mi clínica anteriormente, pero, pues ellos me decían que era imposible, y fue aquí donde yo encontré, pues, la respuesta correcta, y ustedes fueron los que me ayudaron a tener esa respuesta.

Dra. Pollock: Y, entonces, habías buscado información anterior, anteriormente también.

Carolina:  Sí, yo busqué mucha información y siempre fue imposible, ellos me decían que el único recurso podía ser la inseminación artificial, y que tenían que limpiar el semen de mi esposo, pero, pues, nosotros no lo queríamos así, nosotros queríamos algo, pues, natural y se nos hacía imposible todo, y gracias a Dios, aquí se nos dio suma información y esta el fruto de nosotros aquí.

Dra. Pollock: Muy bien! Y ¿Cómo llegaste a la decisión de tomar PrEP?  Yo me acuerdo que cuando primer vez te conocí, tu esposo no tenia el virus indefectible en la sangre, todavía tenía virus que se pudiera detectar en la sangre, y tomamos un poco tiempo hablando de la posibilidad de PrEP, entonces ¿por qué al final decidiste tomar PrEP?

Carolina:  Porque, ah, bueno, decidimos toma…, decidí yo pues, tomar PrEP porque aquí en este hospital le ayudaron al él a que su virus fuera indefectible, primeramente y yo me sentí más segura, y, este lamentablemente, hay mucha mujeres que no corren con la posibilidad de tener toda la información adecuada sobre la PrEP, pero, aquí están, yo siento que aquí en este hospital están los mejores doctores y que te pueden dar la información necesaria y es por eso que yo tomé ese procedimiento y gracias a Dios todo funcionó. 

Dra. Pollock: Y gracias a ti, pero tú fuiste quien tuvo la fortaleza de pedir información y de tomar la decisión para tomar PrEP y para tener a un bebé, y un bebe tan linda…

Carolina: …saludable…

Dra. Pollock: Y ¿tuviste efectos secundarios de la Truvada, de la PrEP?

Carolina:  No! No tuve ningún efecto secundario y yo, se los aseguro, y creo que hay muchas mujeres que lo deberían de usar como un método, pues nunca sabemos, muchas personas no queremos preguntar y sí, se puede, se puede quedar embarazado y no pasa nada.  A mi no me pasó nada y estoy sumamente contenta y estoy preparada para poder tener otro bebé

Dra. Pollock: Qué bien! en el futuro.  Y ¿cómo fue tu experiencia con tu esposo y alguien más en tu mundo, que supo que estabas tomando la PrEP?

Carolina:  No.  Pues, cada quien sabe, bueno, yo en lo personal, pues mi vida es mi vida y yo tomo mis propias decisiones, y pues nadie de mi familia, pues, solamente su mamá, su papá y unos hermanos saben que él tiene, este, esa enfermedad. No es necesario que lo sepa toda su familia si tu quieres, lo puede saber, sino, pues, tú, tú puedes tus propias decisiones, a quiénes decirles y aquí sabes que la información es confidencial

Dra. Pollock: Verdad, y ¿tu esposo te apoyó en tomar la PrEP?

Carolina:  Sí, él me apoyó, pues los dos queríamos un bebé, siempre soñábamos con tener un bebé…y allí está!

Dra. Pollock: Y ¿tienes algunos consejos para otras mujeres que están considerando tomar la PrEP o están considerando tener a un bebé con una pareja con VIH?

Carolina:  Sí, siempre y cuando tengan los proveedores específicos sobre lo que, el caso que ustedes tengan y de lo que estamos hablando, mientras ellos tengan unos proveedores que les puedan dar la información necesaria y adecuada, yo mi  consejo es que sí se puede y pueden tomar sus propias decisiones y averiguar con especialistas como los que yo tengo aquí en San Francisco en el Hospital General.

Dra. Pollock: Muy bien.  Bueno, gracias Carolina por hablar con nosotros hoy y por tener, y por compartir su experiencia con nosotros.

Carolina:  Gracias a ustedes por proveerme esta información y gracias al Hospital General porque se logró lo que queríamos, y sin ustedes, quizás no hubiera sido posible tener este bebé que tenemos ahora con seis meses y con su peso adecuado, y saludable.

Audio.
 

NEW BOOK: Positively Negative: Love, Pregnancy and Science's Surprising Victory Over HIV

"How could someone have sex without a condom, not pass on the virus and have a healthy baby? It went against everything we’ve heard about unprotected sex for decades." - Heather Boerner, author

My PrEP Experience is very excited about this book. We featured one of the remarkable individuals whose story is told in this book on our blog. Our first post about "Poppy" was published in June 2012 - Trying to Get Pregnant and Thankful for PrEP and then, we were delighted to post a very very happy follow-up in November 2013 - Poppy's Story - How A Magnetic Straight Couple Utilized PrEP for Conception.

From a press release:

Positively Negative: Love, Pregnancy, and Science’s Surprising Victory Over HIV
($2.99, Amazon, July 2014) takes readers behind the scenes of the crucial last 15 years of the crisis, when scientific detectives forged a new understanding of the virus and the potent antiretroviral medications that would tame it.

Then, it follows two HIV-affected couples (in which one person has HIV and the other does not) as they pioneer a path to parenthood, harnessing the power of the new science in the service of the most natural of all drives—the formation of a family (including Poppy!)

In 65 brief pages, veteran journalist Heather Boerner weaves a narrative that’s part love story and part medical mystery, all in language that it’s easy for readers to understand.

In it, readers will learn:

• How HIV can affect heterosexual couples and their desire for parenthood;

• How HIV medicines have changed the futures of HIV-positive people and those they love;

• How babies can be born without HIV even though a parent has the virus;

• What it means when the news talks about pre-exposure prophylaxis (PrEP), Truvada, and treatment as prevention;

• How condoms went from the de facto safe-sex method to one of several options;

• How to safely conceive a baby with one’s HIV-positive partner;

• How far we have to go to implement the science and get to zero new HIV cases.

Order the book here.

 

Trying to Get Pregnant and Thankful for PrEP

by an HIV-negative spouse

I've been married to my HIV+ husband for over ten years.

A few years ago we decided we wanted to try to get pregnant.

After years of researching and many disappointments, we decided to try to conceive naturally. Luckily, I had a doctor that was willing to work with us, who respected our choices, and wanted to do whatever she could to mitigate my risks.

She prescribed me Truvada. I began taking it for a month before my husband and I had unprotected sex, and after about two years of trying...we are still not pregnant, but I remain negative.

I realize our choices are risky, but there are not many realistic options for couples in our position who want to conceive. Sure, there are fertility treatments, we looked in to them all, not one fertility treatment option worked for us for one reason or another.

Taking the Truvada does not make me "reckless" in my decision to have unprotected sex, it makes me feel supported by a community of doctors and advocates, who recognize the nuances of my situation, and are doing all they can to help me stay negative.

I understand the risks I'm taking. I don't minimize them just because I'm using Truvada.

It is frustrating to hear experts say that prescribing Truvada to someone could give them an unrealistic sense of safety from becoming HIV+. I'm sure that's true for some...but judging from my own REAL (not hypothetical) experience, it makes me more aware of the risks I'm taking. I am reminded of those risks on a daily basis, every time I open that bottle and swallow that blue pill. I don't take them lightly. If I did, I wouldn't go through the trouble of using Truvada.

I've jumped a lot of hurdles to get to this place....through legislative changes, doctors with unbelievable and blatant prejudice, and all the disappointments that go with failing to conceive.

What has angered me the most, is watching and listening to doctors, politicians, and experts decide what my choices and risks should be.  For most of them, it is their job. But for me....it is my life.

Their opinions and decisions trickle down to impact my life in very real ways. From not being able to utilize certain fertility treatments because the Center for Disease Control won't establish guidelines, (even though I am legally entitled to those treatments), to walking past the baby apparel section at the store, to seeing that negative pregnancy test every month.

With all the complications and legal limitations of our situation, I am thankful for the opportunity to use Truvada. For now, it is my only option. And I think its a good one.

To read more about my journey, check out my blog (HIV negative spouses.)