Providing fertility care to those with HIV: Time to re-examine healthcare policy

Approximately one million Americans are infected with human immunode.ciency virus type 1 (HIV- 1). Most of them are young heterosexual adults of reproductive age. Many desire to have children. Highly active antiretroviral therapy (HAART) has dramatically altered the clinical course of this disease. As a result of HAART the general health and life expectancy of HIV-1 seropositive men is much improved. Assisted reproductive techniques that separate motile sperm from seminal plasma and non motile cells known to harbor virus has been offered as a means of reducing viral transmission to the uninfected female desiring to become pregnant. Although this treatment has been available in Europe for more than a decade, very few centers in the United States provide HIV-1 serodiscordant couples options for reproductive care. In light of mounting evidence of the safety of treatment, and fueled by an increasing demand for reproductive services by HIV-1 serodiscordant couples, the Center for Women’s Reproductive Care at Columbia University established a program for addressing their needs. Major ethical principles related to autonomy, nonmaleficence, beneficence, and justice were individually considered in deciding to proceed with treatment. © 2003, Taylor & Francis Group, LLC. All rights reserved.