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HIV-positive: Safely FATHER children? and related questions

Nov 29, 1996

A good friend of mine recently tested positive for HIV. In addition to worries about his own health, he's devastated that he can now never safely father a child. So I pose this question to you: If he undergoes therapy with protease inhibitors that successfully reduces the HIV in his body to below detectable levels -- as has been done in many people -- then would it at all be possible for his semen to be free -- or free enough -- of the virus to safely father a child through artificial insemination? And if the virus cannot be reduced in his body, can his sperm be "cleansed" of it in a lab setting before artificial insemination? Can HIV exist within individual sperm cells, or only in the semen that carries them? If it's not acutally in sperm cells, couldn't they be separated and considered safe for reproduction? Thanks for your thoughts on this very complicated issue!

Response from Dr. Cohen

I have been sitting on these three questions for awhile, trying to find an answer but without success. I have heard this subject discussed at meetings, but have not been able to find out who might be doing this kind of thing in the U.S. Perhaps I can do what Dear Abby does, and ask my readers if they have any information.

I would just speculate that it while it might be possible to reduce the risk of transmission to the mother, it would probably not be possible to make it completely risk-free.

Accessing treatment at HIV clinics
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