Public Responds to HIV-Positive Individuals’ Reproductive Choice
Following an Australian fertility clinic's decision this week to approve an HIV-positive woman's request for in vitro fertilization to become pregnant, an editorial appearing in The Age says, "Monash In-Vitro Fertilization center was right to decide that otherwise healthy women with HIV should be offered IVF help." While there are "still legal issues to be explored before the woman in this test case will be allowed treatment," the editorial maintains that "the principle that such women should not be rejected out of hand, and that each case must be assessed on its merits, is sound. IVF is already offered to couples who need its screening to eliminate genetic problems or other illness. HIV infection constitutes a similar scenario." With the use of antiretroviral therapy, HIV-positive individuals can expect to live for many years "with a chronic but manageable condition," the editorial says, concluding, "There is certainly no moral reason to deprive people with HIV of parenthood. They are entitled to as full a life as modern medicine can offer them" (The Age, 8/15).
Bonnie Erbe Sounds Off
It may seem "nothing short of absurd to become pregnant ... if [there is] a chance a mother might pass [HIV] on to her child or die before the child reaches maturity," Bonnie Erbe, host of the PBS program "To the Contrary," writes in her Scripps Howard News Service/Nando Times column. But medical advances "have spun these concerns upside down," she adds, noting that antiretroviral drugs have extended the lives of people with HIV and reduced the risk of mother-to-child HIV transmission from 25% to 1%, or "less than half the chance of any child being born with some sort of birth defect." The CDC estimates that 6,000 HIV-positive women give birth in the United States each year, but with the routine use of antiretrovirals, only 300 to 400 babies currently are born with HIV. Erbe points out that "even if these women can rationalize their decisions by saying their children will be born disease-free, that still leaves two issues unresolved." First, HIV-positive women must adhere to a regimen of "dangerous and toxic drugs" throughout their pregnancies to prevent the progress of their disease into AIDS, and there are an insufficient number of longitudinal studies to show whether these drugs create long term health problems for their children. The second concern is maternal longevity. Erbe asks, "Is it fair for any parent to bring a child into this world knowing he or she will die before it is old enough to fend for itself?" This question is of particular concern for single parents. "Single women who are HIV-positive and contemplating pregnancy may be more concerned about sating their own desires and downplaying the child's needs -- hence they should forgo pregnancy," she says. But Erbe acknowledges encountering her "own unexpected prejudice" when asking these questions and "suspect[s] many people might harbor the same double standards" (Erbe, Scripps Howard News Service/Nando Times, 8/13).