June 26, 1987

Counseling the HIV-Positive Woman Regarding Pregnancy

Author Affiliations

Southwest Biomedical Research Institute Scottsdale, Ariz

Southwest Biomedical Research Institute Scottsdale, Ariz

JAMA. 1987;257(24):3361. doi:10.1001/jama.1987.03390240067011

To the Editor.—  Genetic counseling today is a nondirective process in the sense that patients are not told what they should do. In genetic counseling, the facts of the situation are determined and communicated to the patient together with the reproductive options, and the patient makes the decision.1 This nondirective process has been applied to genetic and chromosome disorders as well as to environmental factors that may injure the fetus, such as radiation and chemical exposure. The nondirective nature of genetic counseling puts the informed decision making squarely in the hands of the patient and is part of the move toward greater patient autonomy.As Francis and Chin2 have recently observed, "Human immunodeficiency virus (HIV) is one of the most virulent infectious agents ever encountered. This virus, estimated to kill up to half of those infected, has spread to more than 1 million Americans. There is no safe