title: People living with HIV and procreation: 30 years of progress from prohibition to freedom?
abstract: The emergence of human immunodeficiency virus (HIV) infection in the 1980s drastically changed the prospects of conceiving a child for the man or woman infected with the virus. Advances in treatment then made it possible to envisage pregnancy while decreasing the risk of transmission to the child when the mother was infected. For couples where one partner was HIV-positive and who desired a child, recourse to medical help, notably medically assisted procreation, was discouraged, and very few centres offered such assistance in the 1980s and 1990s. Improved knowledge of viral excretion in the genital tracts, together with more effective treatment, made it possible to envisage medically assisted procreation for these couples, allowing them to have a child while at the same time likely reducing the risk of transmitting HIV to their partner. Several programmes have demonstrated their effectiveness in this domain. Owing to continually increasing knowledge over the past decade, natural conception can now be proposed. Couples where one or both partners are HIV-positive may opt for medically assisted procreation or natural reproduction. Specialists in reproductive medicine and HIV specialists need to provide couples with objective information allowing them to achieve near-optimal conditions that minimize HIV transmission risk. Couples will then be able to choose freely the mode of procreation most appropriate for them.
authors.affiliation: Université Toulouse-III Paul Sabatier, Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), Toulouse, France CECOS, Centre Hospitalier Universitaire Paule de Viguier, Toulouse, France bujan.l@chu-toulouse.fr.
authors.forename: L
authors.initials: L
authors.lastname: Bujan
authors.affiliation: INSERM U1043, CPTP, Centre Hospitalier Universitaire Toulouse-Purpan, BP 3028, F-31024 Toulouse, France Université Toulouse-III Paul Sabatier, CPTP, F-31024 Toulouse, France Laboratoire de Virologie, Centre Hospitalier Universitaire Toulouse-Purpan, F-31059 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Pasquier
mesh_terms: D000328:Adult; D005193:Family Planning Services / Q000266:history*; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D012098:Reproduction; D027724:Reproductive Techniques, Assisted / Q000941:ethics; D018570:Risk Assessment
keywords: assisted reproductive technologies; human immunodeficiency virus; procreation; serodiscordant couples; spontaneous conception