Document 1018
 DOCN  M94A1018
 TI    Artificial insemination with processed sperm in HIV-discordant couples.
       Prospective 2 year trial.
 DT    9412
 AU    Sonnenberg-Schwan U; Reuter U; Jaeger H; KIS-Curatorium for
       Immunedeficiency, Munich, Germany.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):228 (abstract no. PB0927). Unique
       Identifier : AIDSLINE ICA10/94371557
 AB    OBJECTIVES: The wish for a child is often very dominant in
       HIV-discordant couples (male partner HIV-infected) often resulting in
       neglecting condom use. Thanks to artificial insemination (= AIH) with
       the partner's processed semen it is now possible to realize this wish at
       a drastically reduced risk of infection. The application of the
       treatment--accessible to our knowledge only in Italy and Germany--led to
       the birth of several uninfected children (In Germany 7, in Italy 17).
       This study investigates the psychological and psychosocial impact of
       treatment and pregnancy. METHODS: Since Oct. 1991 35 HIV-discordant
       couples have contacted us. 22 couples decided to undergo AIH and were
       investigated by means of semi- and standardized questionnaires and
       structured interviews as to socio-demographics, psychological and
       physical state, stress factors, motivation, perspectives of life and
       social support. RESULTS: 25 inseminations in 9 couples of our study
       group resulted in the birth of three children, one miscarriage and one
       ongoing pregnancy, all without seroconversion. When first interviewed
       33% of the couples lived isolated without any social partners being
       informed about the infection. The prospect of treatment led to
       psychological relief and a more optimistic perspective of life. A two
       years' observation of two successfully treated couples shows a high
       reduction of distress. All couples perform safer sex. However, lack of
       treatment capacities, disappointing medical results and unsuccessfull
       inseminations produce severe strains. DISCUSSION: Spreading information
       about the treatment is important as it has a strong preventive impact,
       and there are still few HIV-discordant couples as well as councellors
       and physicians informed about this research. The study provides guiding
       for all professions confronted with the complex psychological, medical
       and ethical aspects of the wish for a child in couples facing the strain
       of HIV-infection. Since there are inquiries for AIH from all over the
       world, treatment capacities should be increased and decentralized.
 DE    Female  Human  HIV Infections/*PREVENTION & CONTROL/PSYCHOLOGY
       *Insemination, Artificial/PSYCHOLOGY  Male  Prospective Studies
       Spermatozoa  MEETING ABSTRACT

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