ART in HIV-infected couples - Has the time come for a change of attitude?

Today, in developed countries, many HIV-infected people remain in good heal th thanks to antiviral medication. A growing number of them want to have ch ildren, Medical possibilities for preventing contamination of the partners of seropositive men, through assisted reproduction, and of children thanks to antiviral medicines during pregnancy, are summarized. These changes resu lt in ethical considerations which lead the authors to question the convent ional systematic medical advise against pregnancy and has encouraged them t o assist reproduction for a number of these couples. Today, the balance bet ween the importance of the message of prevention and the benefit for patien ts of being assisted in their desire for a child has tilted towards medical intervention, It would seem legitimate today to intervene in the most favo urable situations rather than see these couples take the risk of spontaneou s conception outside health care structures, This implies the need to adapt medical structures (separate laboratory, appropriate procedure, precise pr otocols). This approach, which is coherent from the scientific point of vie w, respects both the autonomy of people carrying HIV as well as the essenti al interests of the child, in being born uninfected, and also has the enorm ous advantage of allowing access to parenthood without destroying the consi stency of the message of prevention of sexual contamination.