A short paper in this week's British Medical Journal (BMJ) suggests that UK IVF clinics are discriminating against HIV (human immunodeficiency virus) positive men and women. A spokesman for the Terrence Higgins Trust, a UK AIDS charity, was quick to agree: 'We do not know on what grounds these clinics are refusing to give treatment, but it certainly is not medical.'
Are there medical grounds for refusing IVF to HIV positive men and women, or is it all just a case of unjustified discrimination? Since the BMJ study did not ask clinics why they adopted a particular policy towards prospective patients who are HIV positive, it is difficult to know what the grounds for refusal are. But other sources tell us that, at least in the case of women, a mixture of medical and non-medical worries apply.
If a woman is HIV positive, she has a risk of passing on the virus to her baby. However, modern drug therapies, accompanied by a caesarean section and bottle feeding, can reduce the risk of transmission to just a few percent. But this risk alone seems scant reason to refuse treatment, as 63 percent of responding clinics said they would do. After all, people at risk of passing on a genetic condition to their children (a risk which could be as high as 50 percent) are not prevented from having children - nor should they be.Apart from this medical consideration, HIV positive women who seek to conceive do run the risk of leaving their child motherless if they die from AIDS (acquired immune deficiency syndrome). But modern medicine means that people are living with HIV for longer and longer and not developing AIDS for many years. Further, there are other conditions where risk of recurrence is high (some cancers, for instance). Yet these women are not prevented from having children.
Perhaps it is these two factors combined - risk of transmission and risk of leaving a child motherless - that is leading clinics to refuse requests for IVF from HIV positive women. But it seems unfair to single out HIV positive women who need IVF, when there are probably many more HIV positive women who do not need IVF to get pregnant. These women are left to make their own decision about whether the risk of their dying is significant enough to stop them becoming a mother. Why can't the same privilege be extended to those who need IVF?