Abstract
Some people living with HIV (PLWHIV) who wish to have children seek assisted reproductive techniques to achieve conception, others pursue adoption. Existing research indicates that prohibitive costs and limited facilities specialising in HIV-related infertility treatment hinder access. Other studies highlight reluctance by adoption agencies to consider PLWHIV, although their experiences have scarcely been explored. This qualitative study utilised Interpretative Phenomenological Analysis (IPA) and social constructivism to explore experiences of pursuing infertility treatment and adoption. Through HIV voluntary organisations, the study recruited 11 participants living with HIV who had received support with accessing fertility treatment and adoption services. In-depth semi-structured interviews were conducted, providing detailed accounts of the experiences of participants. The study protocol was reviewed by the Terrence Higgins Trust and received ethical approval from the University of Surrey Ethics Committee. The findings suggest that HIV-related infertility, fertility treatment and adoption are socially constructed. Therefore, the reality of participants’ experiences was influenced by their engagement with those services and the wider social context. Childlessness was seen as a form of loss. However, seeking alternative ways of parenting represented resilience. The findings of this study present fertility treatment and adoption experiences as separate entities to reflect the differing discourses and constructs that influenced participants’ life-worlds. The study postulates that fertility treatment is predominantly influenced by the medical model although social and cultural influences contribute to the reality of infertility and the need to address childlessness. Adoption was seen as a last choice when fertility treatment was unsuccessful. However, for homosexual individuals, adoption was considered their only option. Overall, the journey to seek parenthood was motivated by participants’ desire for a normal life, rights to creating families and achieving parenthood. However, pursuing either adoption or fertility was fraught with challenges such as stigma, discrimination, power imbalances, psychological and emotional problems. For many, support from charitable organisations was seen as a source of support that increased resiliency through the journey of seeking and fighting for parenthood. Achieving parenthood was considered meaningful in reconstructing individual identities after coming to terms with HIV as a long-term condition. Contingency planning was an important aspect of implementing stable long-term arrangements for adoptive children in the event of health deterioration. Healthcare and social care services will benefit from education around the current definition of HIV, with implications for enhancing family life. Up-to-date knowledge about HIV will not only improve practice but also enable non-discriminatory practices. This may result in improved experiences for PLWHIV as they seek parenthood.