The first HIV-positive sperm bank in the world has just opened.
According to BBC News, three HIV-positive men, who are all undetectable and thus untransmittable, have signed up to donate their sperm to Sperm Positive. Sperm Positive is the world’s first HIV-positive sperm bank and was created to fight stigma. The bank was created by three charities, Body Positive, the New Zealand Aids Foundation, and Positive Women Inc ahead of World Aids Day on December 1.
Both the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) have confirmed that HIV-positive people who are undetectable are untransmittable. Back in January of this year, the NIH released a press release about a study from its National Institute of Allergy and Infectious Diseases (NIAID) team:
“In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable = Untransmittable (U=U) concept as scientifically sound, say officials from the National Institutes of Health. U=U means that people living with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking and adhering to antiretroviral therapy (ART) as prescribed cannot sexually transmit the virus to others.”
That said, there’s still a significant stigma around being HIV-positive in most social climates.
One of the three donors, Damien Rule-Neal, told Radio New Zealand that he was bullied at work after he revealed his status to his employer. This continued until he eventually left his job.
“We’ve got the science behind it to say that medication makes you untransmittable,” he said. “I’ve seen a lot of my female friends that have HIV go on to have children, it shows that science and medication have given us that ability back.”
Despite this transgression against him, Rule-Neal is undetectable, married, and has two children and three grandchildren. Now, he hopes this new sperm bank will help to spread the undetectable=untransmittable message.
But conservative voices, like the news source Life Site News, have already decried the new sperm bank. Some LGBTQ voices have done the same. Both sides complain about the risk of passing on the disease. In response to this, we have some thoughts.
Forgoing what has already been said about undetectable HIV-status, there is still little recorded risk of father-to-child transmission. While mother-to-child transmission is, unfortunately, commonplace, father-to-child transmission is not so typically reported. Perhaps that’s due to the fact that the father would have to first infect the mother, and experts then subsequently focus on the mother infecting the baby.
In fact, a study published in the journal AIDS Research and Human Retroviruses on September 20, 2018 describes one of the few documented and reported cases of father-to-child transmission. And even then, the incident was widely reported because the transmission was a rare case of blood transfer after birth and not through conception.
“The main message of our paper … is that HIV can be transmitted via the fluid from at least some types of skin blisters,” said study senior author Nuno Taveira, a professor who researches HIV at the University of Lisbon’s Research Institute for Medicines.
That said, the U.S. Department of Veteran Affairs has provided information concerning how a HIV-positive man can conceive a child with a HIV-negative woman without infecting the mother or child.
- The man with HIV takes anti-HIV drugs and has an undetectable viral load; this minimizes the risk of infecting his partner. The couple then has sex without a condom, limited to the time the woman is ovulating (this reduces the number of times they have unprotected sex and thus lowers the risk of HIV transmission). In addition, the HIV-negative female partner may take HIV medications as prophylaxis to reduce her risk of infection with HIV, beginning in advance of attempts at conception and continuing afterward (this is called pre-exposure prophylaxis or PrEP), though it is not clear that this step is necessary if the man’s HIV viral load is undetectable.
- Sperm washing with in vitro fertilization or intrauterine insemination may be considered. Sperm washing is intended to isolate individual sperm from the HIV virus in the semen. These methods require the assistance of a reproductive specialist or fertility clinic. For couples with different HIV status, these services are legal in some states, but not in all.
So not only do many health institutions recognize the fact that undetectable=untransmittable, but father-to-child transmission is a rarely reported case. That said, there is, honestly, not enough data on the subject to know for sure. More research is necessary.
Remember, mothers-to-be will always be volunteers in using blood from undetectable sperm donors. But will they? And will Sperm Positive fight stigma like its set out to do?
Update: This post has been updated to include information about father-to-child transmission to elaborate on concerns with the sperm bank. In addition, a section provided by the U.S. Department of Veteran Affairs has been added.