[HIV-infected women's decision to continue or terminate pregnancy]

Our purpose was to determine how women's knowledge of HIV seropositivity influenced their decision on whether to continue pregnancy. The study included 2,023 pregnant women from 220 maternities through France, 595 in 1987, 691 in 1988 and 737 in 1989. Approximately one half decided to continue pregnancy. This proportion was higher in the Paris region (58.9 percent) than in the other regions of France (38.2 percent). Motivations for continuing pregnancy included a visceral desire to have a child, a means of transcending one's mortality, a gift to the partner, a means of rehabilitation, a denial of the pathologic state or the conviction that the infant will be unaffected. Motivations for terminating pregnancy included fear of contaminating the infant, fear that pregnancy could accelerate their own disease progression and fear that the infant will become orphaned. The attitude of physicians towards pregnancy in HIV infected women is discussed. The discovery of an effective treatment decreasing materno-fetal transmission and/or an approach to prenatal diagnosis could offer solutions to this difficult dilemma.