<scp>CHildren</scp> of the Cohort Study ( <scp>CHOC</scp> ): Exploring parenting desire among people living with <scp>HIV</scp> in Switzerland

BACKGROUND: Although HIV is now a chronic condition with an excellent life expectancy, some personal aspects affecting people living with HIV (PLWH), such as parenting desire, are relatively understudied. This study aimed to explore parenting desire among PLWH in Switzerland. METHODS: From September 2022 until January 2024, PLWH (participants) enrolled in the Swiss HIV Cohort Study (SHCS) and followed up at seven university/cantonal hospitals were invited to complete a structured questionnaire co-designed with patient and public involvement. There were no exclusion criteria. The questionnaire covered parenting desire, the perceived influence of HIV on family planning and whether future parenthood had ever been discussed with an HIV physician. RESULTS: Of the 5038 PLWH attending SHCS clinic visits, 3006 (59.7%) completed the questionnaire (2974 (98.9%) complete datasets analysed). The median age was 54 years (IQR 44;61), 27% were female, 39% were men who have sex with men (MSM), 16% were of Black ethnicity, 94.5% had HIV RNA plasma viral loads <50 copies/ml. Overall, 515 participants (17.3%) expressed a desire for parenting, with a desire associated with being aged <45 years and of Black ethnicity, and 506 (17%) stated that HIV influenced family planning decisions. Discussing parenthood was associated with being female, Black, heterosexual and in a stable relationship. Among heterosexual male participants, 26.1% had ever had such discussions, compared to 6.8% of MSM. CONCLUSION: In this sample of PLWH, a minority expressed parenting desire, possibly due to high median participant age, and 17% felt HIV influenced family planning decisions. While female participants were more likely to have discussed future parenthood than male participants, there was a further disparity between heterosexual men and MSM. Whilst surrogacy is prohibited in Switzerland, MSM may have access to parenthood in other ways. Our findings suggest there is room for HIV physicians to proactively invite parenting discussions with all PLWH.