People living with HIV have come a long way since the discovery of the virus, when the emergence of symptoms was a death sentence. The rise of antiretroviral treatments and other life enhancing measures have both greatly extended the lives of those living with the infection and improved their quality of life. HIV-positive individuals can focus on life-long goals, including family, long-term career, and raising a family. “Medical technology has really changed,” said Guy Ringler, M.D., internationally-renowned reproductive endocrinologist. “Individuals with HIV can expect a long life and thus have all the hopes and dreams that uninfected people have.”
Nevertheless, family building for HIV-positive individuals or couples is a tricky proposition. Adoption is of course one avenue, but the stigma associated with HIV can threaten the adoption process, either through the attitudes of the community whose laws have to be satisfied or through less obvious avenues, such as the beliefs of the case-worker. Other options included in vitro fertilization with donated eggs or sperm, and perhaps a surrogate. But what if an HIV-positive person wishes to parent a biologically connected child?
Enter The American Fertility Association (AFA). It is an inclusive organization committed to helping people create their unique path to parenthood by providing leading-edge outreach programs and timely educational information. The AFA is committed to the principle that everyone – regardless of race, gender, sexual orientation or HIV status – should be able to have a family.
Last year, the AFA honored Elton John and his partner David at their annual fundraiser. Elton and David had shared their own adoption story with the world, and they approached the AFA to express their desire to help people with HIV understand all their options for parenting biologically linked children. The Elton John AIDS Foundation then made a large gift to the AFA to fund what Ringler describes as an “educational program to increase knowledge about treatment options for prospective patients available for men and women infected with HIV.” The resulting project, “Dreams to Reality,” has additional financial support from HIV Assisted Reproductive Technologies.
The “Dream” outreach effort is a three-pronged campaign promoting patient education, training for healthcare professionals, and building support of community organizations. Initially at least, “Dreams” will focus on the Southeast, because the region has the highest HIV infection rates in the country and likewise lacks educational resources in this area, where the science has outpaced public awareness.
“The ability to have one’s own children without the fear of transmitting the HIV virus is a profound advancement in family-building options for men and women living with the virus,” said Ringler, medical director of the outreach effort. “It is essential for patients with HIV to be informed about the fertility treatment options available that can help them have children safely, with minimal risk of transmitting the HIV virus to their sexual partners, reproductive partners, or to their children.”
The technology exists, Ringler explains, for “men and women with HIV to have children safely through a combination of HIV therapies and assisted reproductive therapies – a combination of sperm wash and in vitro or surrogacy for instance.” A recent article Ringler references reviewed medical articles covering over 8,000 cases where the sperm wash treatment was used. “Effective protocols minimize risk. No published studies involved cases where transmission of HIV occurred. Adding effective antiretrovirals have also improved reproductive options, and a combination provides a very safe way for men with HIV to have their own genetic children. For women, treatments exist that can dramatically reduce the risk that HIV will pass to children from an infected mother.”
Nashville is an early beneficiary of the “Dreams” program. On August 16, Guy Ringler led an educational program, hosted at Covenant of the Cross. Interested folks were invited to the free lunch-and-learn or to join via webcast.