Insemination of HIV-negative women with processed semen of HIV-positive partners

Semprini, E.; Levi-Setti, Paolo Emanuele; Bozzo, Maddalena; Ravizza, Marina; Taglioretti, A; Sulpizio, Patrizia; Albani, Elena; Oneta, M.; Pardi, Giorgio

doi:10.1016/0140-6736(92)92495-2

Cited by 296 publications

(53 citation statements)

References 2 publications

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“…Manual insemination (28) and medical male circumcision may reduce transmission risks for uninfected men with HIV-infected partners (29–32). Sperm processing and assisted reproduction is considered standard of care for male-infected couples in higher-income countries, yet costs and limited availability make this inaccessible to most persons living with HIV (PLWH) (33–36). The South African constitution protects reproductive rights of PLWH and clinical guidelines suggest a range of feasible risk-reduction strategies including ART for the infected partner, timing sex without condoms to peak fertility, and manual insemination for female-positive couples (37,38).…”

Section: Introductionmentioning

confidence: 99%

“If I don’t use a condom … I would be stressed in my heart that I’ve done something wrong”: Routine Prevention Messages Preclude Safer Conception Counseling for HIV-Infected Men and Women in South Africa

et al. 2015

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Intended conception likely contributes to a significant proportion of new HIV infections in South Africa. Safer conception strategies require healthcare provider-client communication about fertility intentions, periconception risks, and options to modify those risks. We conducted in-depth interviews with 35 HIV-infected men and women accessing care in South Africa to explore barriers and promoters to patient-provider communication around fertility desires and intentions. Few participants had discussed personal fertility goals with providers. Discussions about pregnancy focused on maternal and child health, not sexual HIV transmission; no participants had received tailored safer conception advice. Although participants welcomed safer conception counseling, barriers to client-initiated discussions included narrowly focused prevention messages and perceptions that periconception transmission risk is not modifiable. Supporting providers to assess clients’ fertility intentions and offer appropriate advice, and public health campaigns that address sexual HIV transmission in the context of conception may improve awareness of and access to safer conception strategies.

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Section: Introductionmentioning

confidence: 99%

“If I don’t use a condom … I would be stressed in my heart that I’ve done something wrong”: Routine Prevention Messages Preclude Safer Conception Counseling for HIV-Infected Men and Women in South Africa

et al. 2015

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“…There were no seroconversions in the 29 women or their babies. 34 Then in 1997 he reported 200 pregnancies with no HIV seroconversions from more than 1000 AIH treatments of over 350 women. 35 However, because of the low rate of sexual transmission of HIV per episode the safety of Semprini's approach is not proven.…”

Section: Fertility In Hiv Infected Individualsmentioning

confidence: 99%

Use of assisted reproductive technology to reduce the risk of transmission of HIV in discordant couples wishing to have their own children where the male partner is seropositive with an undetectable viral load: Table 1

et al. 2003

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The advances in treatment of HIV and the introduction of polymerase chain reaction assay for the virus now make it acceptable for HIV discordant couples where the male partner is seropositive to attempt to conceive through artificial insemination by husband (AIH) or via in vitro fertilisation. With undetectable viral load and washed sperm, there is minimal risk of transmission of HIV to the female partner, children, other patients, or staff. We describe the development of a programme of AIH for HIV discordant couples and the reasoning behind offering such a programme.

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“…The technique, pioneered by Augusto Semprini in Milan, involves the ''washing'' of semen to remove everything but the actual spermatozoa. 3 After washing, the sperm can be combined with ova from the female partner using in vitro fertilisation (IVF) techniques or direct injection of the sperm into a selected oocyte-intracytoplasmic sperm injection (ICSI). Since the technique has been offered, three hundred children have been born with no reports of seroconversions in children or uninfected partners.…”

mentioning

confidence: 99%

Should HIV discordant couples have access to assisted reproductive technologies?

Spriggs

Charles²

2003

J Med Ethics

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In this paper we identify and evaluate arguments for and against offering assisted reproductive technologies (ART), specifically IVF, to HIV discordant couples (male partner HIV positive, female partner HIV negative). The idea of offering ART to HIV discordant couples generates concerns about safety and public health and raises questions such as: what is an acceptable level of risk to offspring and should couples who want this assistance be subject to selection criteria; should they undergo scrutiny about their suitability as parents when those who are able to conceive naturally face no such scrutiny and people with other illnesses are given access to ART? We conclude that offering ART to HIV discordant couples is likely to produce more benefit than harm and violates no ethical principles. Nevertheless, a decision to deny treatment need not constitute unjustified discrimination.

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Insemination of HIV-negative women with processed semen of HIV-positive partners

Cited by 296 publications

References 2 publications

“If I don’t use a condom … I would be stressed in my heart that I’ve done something wrong”: Routine Prevention Messages Preclude Safer Conception Counseling for HIV-Infected Men and Women in South Africa

“If I don’t use a condom … I would be stressed in my heart that I’ve done something wrong”: Routine Prevention Messages Preclude Safer Conception Counseling for HIV-Infected Men and Women in South Africa

Use of assisted reproductive technology to reduce the risk of transmission of HIV in discordant couples wishing to have their own children where the male partner is seropositive with an undetectable viral load: Table 1

Should HIV discordant couples have access to assisted reproductive technologies?

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