title: Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.
abstract: The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice.
authors: Department of Obstetrics and Gynaecology, College of Medicine, Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.
authors: Ouj
authors: O
authors: Umeora
authors: Fn
authors: F
authors: Chukwuneke
keywords: Confidentiality; Disclosure; Ethics; Family; HIV/AIDS; Infertility
references: BMJ. 1991 Jun 15;302(6790):1447-50
references: 2070114
references: CMAJ. 1998 Jun 2;158(11):1473-9
references: 9629112
references: Trop Doct. 2007 Apr;37(2):92-4
references: 17540089
references: J Med Ethics. 2005 Feb;31(2):73-7
references: 15681669
references: Lancet. 1991 Mar 23;337(8743):709-11
references: 1672184
references: J Obstet Gynaecol. 2008 Apr;28(3):323-6
references: 18569479
references: Hum Reprod. 2004 Nov;19(11):2454-6
references: 15459168