Re: Sero- discordant couple would like to have baby.

[Guest guest]

Dear FORUM,

Never heard pf 'sperm washing' and the whole idea seems as ridiculous where

some Kerala quacks were offering " blood washing' to 'remove hIV from the blood'.

Why not adopt? There are lakhs of orphans on the streets and many are

because their parents have died from AIDS.

Don't be so self-righteous and self-centered, there is a lot of work to be done

and one way you can show how concerned you are is to adopt a child...

Ashok Row Kavi

Mumbai

e-MAIL: <arowkavi@...>

[Guest guest]

Sero- discordant couple would like to have baby response from Asia Pacific

Network of People Living with HIV/AIDS (APN+)

Dear AIDS India,

On behald of the Asia Pacific Network of People Living with HIV/AIDS (APN+) I

would like to respond to the suggestion by Ashok Row Kavi whom one must assume

is neither HIV positive or his spouse and is unable to put himself of the

position of the sero discordant couple whose natural desire is to produce

offspring.

I would like to quote from the Asia Pacific Network of People Living with

HIV/AIDS (APN+) Advocacy document 'We have Rights' - the specific section is

highlighted and underlined below

All people should enjoy the same rights as their neighbours, but because the

AIDS epidemic is driven by fear and ignorance, people diagnosed with HIV are

highly-stigmatised. Stigma leads to discrimination and violations of people’s

rights.

Right to health

“Everyone has the right to a standard of living adequate to the health and

well-being of him[or her]self and his [or her] family including… medical care,

and… to security in the event of unemployment, sickness, disability, widowhood…

or lack of livelihood in circumstances beyond his [or her] control” Universal

Declaration of Human Rights, Article 25

Every Asian country has signed some international agreement relating to its

citizen’s right to health. Every person, regardless of their HIV status should

be able to exercise their right to the highest attainable standard of physical

and mental health in their country and to share in scientific advancement. But

in many places, people in positions of power do not respect people’s rights; and

many people are terrified to disclose their HIV status; consequently they are

compromised in their right to support and medical services.

“I was in labour. The hospital staff refused to deliver my baby and they sent me

away in a rickshaw.” (India)

Access to antiretrovirals

“Every human being has the inherent right to life.” International Covenant on

Civil & Political Rights, Article 6

We also have the rights to share the benefits of scientific progress. Increased

access to antiretroviral HIV drugs (ARVs) enables more HIV-positive people to

engage widely as public health educators, counsellors, treatment educators,

project managers and policy makers. It will also help to change people’s

perspectives about people living with HIV.

Although ARVs are available at reasonable cost, most people who need them cannot

get them. Countries can apply for ARVs to the Global Fund to fight HIV/AIDS,

Malaria and TB. Applicant’s Country Coordinating Mechanisms (CCMs) should

include people living with HIV on their committees.

Right to freedom from inhuman or degrading treatment

“No one shall be subjected to torture or to cruel, inhuman or degrading

treatment or punishment. In particular, no one shall be subjected without his

free consent to medical or scientific experimentation.” International Covenant

on Civil & Political Rights, Article 7

Often people do not know they are tested for HIV until they are told of their

results. People coerced into HIV testing (pregnant women, overseas workers, sex

workers or people in the military, drug rehabilitation units or prisons) are

significantly more likely to experience human rights violations than people who

choose to test.

Many people coerced into HIV testing are also coerced into clinical trials of

drugs, with little knowledge about the purpose or risks of the trial; only a

small proportion receive ongoing treatment after the trial. We must outlaw

mandatory HIV testing.

Right to privacy

“No one shall be subjected to arbitrary or unlawful interference with his

privacy, family, home or correspondence, nor to unlawful attacks on his honour

and reputation.” International Covenant on Civil & Political Rights, Article 17

Nobody has the right to disclose your HIV status to anybody without your

permission. Breaches of privacy can result in gross violations of rights,

including the right to life.

“The newspaper disclosed that a woman with HIV was getting married. Then the

whole town knew and I was chased away with my husband. They threatened to kill

us. It happened again in the next town – six times it happened. We had to move

very far away.” (Indonesia)

Women living with HIV face significantly greater levels of discrimination than

men do, both in the family and in the community. Right to liberty and security

of person

“Everyone has the right to liberty and security of person. No one shall be

subjected to arbitrary arrest or detention… Anyone who has been the victim of

unlawful arrest or detention shall have an enforceable right to compensation.”

International Covenant on Civil & Political Rights, Article 9

You should be allowed to live free from violence and harassment. However, people

known to have HIV are driven out of homes, temples, shops and schools. Many

women are beaten by their husbands after diagnosis.

No one should be detained because of their HIV-positive status, even outside

their country of residence.

“I was separated from all of the other people. They shouted that I would be sent

back to my country. I was quarantined by myself but I did not know why. I did

not know what I had done.” (Indonesia) Right to work

“Everyone has the right to work, to free choice of employment, to just and

favourable conditions of work, and to protection against unemployment” Universal

Declaration of Human Rights, Article 23

A high proportion of people diagnosed with HIV subsequently lose their

livelihoods. This is particularly the case with overseas migrant workers.

“I was told I could no longer work there because I had AIDS. I didn’t even know

I had been tested for HIV.” (Philippines)

Right to choose a partner and a family

“Women have the right to freely choose a spouse and to enter into marriage only

with their free and full consent.” CEDAW, Article 10

Nobody should be coerced into sex if they do not want it yet women have little

power to protect themselves from forced sex and unwanted pregnancies. Many women

who undergo mandatory HIV testing during pregnancy (“opt-out” testing) receive

little or no information about HIV and after diagnosis, are coerced into

unwelcome choices, including unnecessary sterilisation.

Laws to uphold women’s reproductive and sexual rights must be addressed

urgently:

Marital rape is a crime and should be recognised and treated accordingly

HIV-positive women should have the right to have children when they want to, and

be supported to, without judgment

HIV-positive women should not be pressurised either to continue with a pregnancy

or to terminate it and should be fully supported in their decision, without

judgment, and given full, unbiased, correct information

Sterilisation of HIV-positive women should be outlawed unless women give their

full, informed, unpressured consent

HIV-positive pregnant women should receive ARV drugs to protect the HIV status

of their children and to maintain their own health after the birth of their

child.

For more information on APN+ and its partner PLWHA network organisations please

contact:

Greg Gray

Regional Coordinator

Asia Pacific Network of People Living with HIV/AIDS

1701 One Pacific Place

140 Sukhumvit Road, Bangkok, 10110

Thailand

Tel: +662 2546090

Mob: +661 5540986

Fax: +662 2551128

E-mail: <ggray@...>

[Guest guest]

Dear Sunny and Readers,

Just because some people haven't heard of sperm washing techniques don't

despair. I know of a wonderful lot of negative biological children born to sero

discordant couples where either mothers or fathers have been HIV positive and

scientific sperm washing techniques should not be confused with blood washing

because there is no science in the latter.

Only those people who are denied the opportunity to conceive naturally

understand the love and connection of a natural biological child which

represents a miracle that is often taken for grantedby those who conceive

without effort.

I am also sure that there are some people in India already fostering orphans and

of course more can be done but that does not mean that advances in the

scientific management of conception should be restricted to non HIV affected or

infected families. It goes down the track of the deserving and undeserving

parenting category or class. We don't do it to diabetics so why should we do it

to people affected with viral complications most of which can be managed with

competent treatment, information and advice.

Geoffrey

E-mail: <gheaviside@...>

[Guest guest]

Dear Forum,

Having a child is an important personal and social need for majority of Indians

( and even in other countries- see the boom of Infertility treatment business in

the recent years).More over having a child helps many PLWHAs to cover up their

HIV status.

It is not easy to face two stigmas at the same time - being HIV positive and

having infertile especially for a married lady

in India.I hope Mr Kavi will try to understand this.

Being an HIV physician I have faced this problem more than once.

Sperm washing should be available in many centers in India but I don't think any

IVF centered in India will be ready to do IVF for an HIV discordant couple. This

involves many counseling and ethical issues other than the stigma and

discrimination involved.

One of my patients - discordant couple -were ready to undergo AID

(artificial insemination using donor sperm).The Gynecologist was ready to do AID

for them. But he insisted on the consent of the couple and in laws. His point

was that if the lady get HIV on a later date and these couple get sick ,it will

be the responsibility of the grand parents to look after the child.

Obviously they were not ready to reveal HIV status to in-laws because

one of the reason for " infertility treatment " was to prove them selves that

they are normal and hide HIV status.

I am interested in further opinion of the forum on this issue.

Ajith

E-mail: <trc_ajisudha@...>

[Guest guest]

Sperm washing techniques are widely used in fertility clinics all over India in

cases of IUI. The technique is used to isolate the sperm and remove other semen

contents( e.g. prostaglandin contained in semen which can trigger painful

uterine contractions and prevent implantation).

Please make enquiries whether the staff at these centres are willing to use the

technique for HIV positive individuals.

" Avina Sarna "

E-mail: <Asarna@...>