Medical Forum / Diseases and Disorders / AIDS / May 2005
sperm doner hiv question
|
|
Thread rating:  |
ml34b@hotmail.com - 06 May 2005 03:19 GMT i don't know how sperm donation works. is the sperm exposed to open air or do they have a system where you deposit it into a vaccum? anyways, i thought hiv can't survive in open air. so how can hiv stay alive in sperm that is donated? from what i understant hiv is not able to survive for more than a few seconds in open air. am i correct on this? thanks for anyones help.
Death - 06 May 2005 03:41 GMT <ml34b@hotmail.com> wrote in message
> i don't know how sperm donation works. May 5, 7:09 PM (ET)
By DAVID CRARY
NEW YORK (AP) - To the dismay of gay-rights activists, the Food and Drug Administration is about to implement new rules recommending that any man who has engaged in homosexual sex in the previous five years be barred from serving as an anonymous sperm donor.
The FDA has rejected calls to scrap the provision, insisting that gay men collectively pose a higher-than-average risk of carrying the AIDS virus. Critics accuse the FDA of stigmatizing all gay men rather than adopting a screening process that focuses on high-risk sexual behavior by any would-be donor, gay or straight.
"Under these rules, a heterosexual man who had unprotected sex with HIV-positive prostitutes would be OK as a donor one year later, but a gay man in a monogamous, safe-sex relationship is not OK unless he's been celibate for five years," said Leland Traiman, director of a clinic in Alameda, Calif., that seeks gay sperm donors.
Traiman said adequate safety assurances can be provided by testing a sperm donor at the time of the initial donation, then freezing the sperm for a six-month quarantine and testing the donor again to be sure there is no new sign of HIV or other infectious diseases.
Although there is disagreement over whether the FDA guideline regarding gay men will have the force of law, most doctors and clinics are expected to observe it.
The practical effect of the provision - part of a broader set of cell and tissue donation regulations that take effect May 25 - is hard to gauge. It is likely to affect some lesbian couples who want a child and prefer to use a gay man's sperm for artificial insemination.
But it is the provision's symbolic aspect that particularly troubles gay-rights groups. Kevin Cathcart, executive director of Lambda Legal, has called it "policy based on bigotry."
"The part I find most offensive - and a little frightening - is that it isn't based on good science," Cathcart said. "There's a steadily increasing trend of heterosexual transmission of HIV, and yet the FDA still has this notion that you protect people by putting gay men out of the pool."
In a letter to the FDA, Lambda Legal has suggested a screening procedure based on sexual behavior, not sexual orientation. Prospective donors - gay or straight - would be rejected if they had engaged in unprotected sex in the previous 12 months with an HIV-positive person, an illegal drug user, or "an individual of unknown HIV status outside of a monogamous relationship."
But an FDA spokeswoman cited FDA documents suggesting that officials felt the broader exclusion was prudent even if it affected gay men who practice safe sex.
"The FDA is very much aware that strict exclusion policies eliminate some safe donors," said one document.
Many doctors and fertility clinics already have been rejecting gay sperm donors, citing the pending FDA rules or existing regulations of the American Society for Reproductive Medicine.
"With an anonymous sperm donor, you can't be too careful," said a society spokeswoman, Eleanor Nicoll. "Our concern is for the health of the recipient, not to let more and more people be sperm donors."
However, some sperm banks, notably in California, have welcomed gay donors. The director of one of them, Alice Ruby of the Oakland-based Sperm Bank of California, said her staff had developed procedures for identifying gay men with an acceptably low risk of HIV.
Gay men are a major donor source at Traiman's Rainbow Flag sperm bank, and he said that practice would continue despite the new rules.
"We're going to continue to follow judicious, careful testing procedures for our clients that even experts within the FDA say is safe," said Traiman, referring to the six-month quarantine.
The FDA rules do not prohibit gay men from serving as "directed" sperm donors. If a woman wishing to become pregnant knows a gay man and asks that he provide sperm for artificial insemination, a clinic could provide that service even if the man had engaged in sex with other men within five years.
However, Traiman said some lesbian couples do not have a gay friend they know and trust well enough to be the biological father of their child, and would thus prefer an anonymous donor.
Dr. Deborah Cohan, an obstetrics and gynecology instructor at the University of California, San Francisco, said some lesbians prefer to receive sperm from a gay donor because they feel such a man would be more receptive to the concept of a family headed by a same-sex couple.
"This rule will make things legally more difficult for them," she said. "I can't think of a scientifically valid reason - it has to be an issue of discrimination."
FDA site: http://www.fda.gov
ml34b@hotmail.com - 06 May 2005 03:48 GMT yes, i saw that article. that is why i posted my question. can someone explain how hiv survives in sperm?
Gary Stein - 06 May 2005 18:28 GMT Well it's really quite simple if you just think about it for a minute. The HIV virus is in the sperm and if the sperm is treated in a manner that keeps the actual sperm cells viable and able to be fertile then the HIV virus is protected right along with it.
As to HIV's not being able to be exposed to air that is true however not applicable in this case because the HIV is protected from direct contact with air by the liquid of the ejaculate. If the sperm was allowed to air dry then yes the HIV virus would die as soon as it came into contact with air absent that it stays alive in the sperm.
Gary Stein
> yes, i saw that article. that is why i posted my question. > can someone explain how hiv survives in sperm? GMCarter - 06 May 2005 23:05 GMT >yes, i saw that article. that is why i posted my question. >can someone explain how hiv survives in sperm? To add a bit to Gary's comments, semen is a liquid that contains sperm as well as a variety of other cells. HIV infects some of these various cells that are found in semen, such as macrophages (or other white blood cells). Cell-free HIV is also found in sperm. The evidence as far as I've seen suggests that HIV does not infect sperm cells or attach to them.
Sperm that winds up in a vagina or an anal canal that is infected is in a warm spot, relatively anaerobic, that allows blood transmission.
Sperm washing can permit an HIV+ man to impregnate his HIV- partner and significantly reduce any risk to her or the baby of becoming infected.
George M. Carter ** Alexander NJ. HIV and germinal cells: how close an association? J Reprod Immunol. 1998 Dec;41(1-2):17-26.
Organon Inc., West Orange, NJ 07052, USA. alexandn@am.father.umc.atzonobel.nl
Whether semen from someone who is HIV-positive can be prepared so that it is safe for insemination is a critical question particularly to couples in which the male is seropositive and the female is seronegative. It is reassuring that some investigators have reported great success in using sperm washing to dramatically reduce HIV levels in the ejaculate. Such reports suggest that if free virus and leukocytes in the seminal plasma are removed, the specimen may be safe for insemination. Whether the virus ever is associated with spermatozoa themselves is not fully understood. In situ hybridization as well as electron microscopic studies have suggested the presence of viral particles but whether these are preparation artifacts or evidence of viable viral DNA is not known. Studies of whether the virus is incorporated into developing spermatozoa or is shed in the reproductive tract will aid in the elucidation of sexual transmission of HIV.
** Semprini AE, Vucetich A, Hollander L. Curr Opin Obstet Gynecol. 2004 Dec;16(6):465-70. Sperm washing, use of HAART and role of elective Caesarean section.
University of Milan, via Carlo Crivelli 20, 20122 Milan, Italy. semprini@esman.it
PURPOSE OF REVIEW: Today, 50% of people living with HIV are women and most have been sexually infected. Highly active antiretroviral therapy (HAART) reduces the rates of both sexual and vertical infection, but maximum protection is achieved with sperm washing and elective Caesarean section. RECENT FINDINGS: Men taking HAART have lower seminal concentration of HIV, and sexual transmission may be reduced. However, a certain percentage of aviraemic men retain viral presence in semen, and unprotected intercourse to achieve fertilization must be discouraged as it carries the risk of sexual transmission of the virus. HIV-discordant couples should be informed that sperm washing can remove HIV from semen, allowing conception without the risk of infection for the seronegative female and eventually the child. In HIV-positive women, perinatal transmission of HIV can be curtailed to less than 2% by using HAART to decrease maternal viral load and offering prenatal preexposure prophylaxis of the fetus, and elective Caesarean section. Each intervention carries specific risks and benefits. The contribution of each preventive arm in achieving fetal protection can only be crudely measured and optimal obstetric management must involve discussion with the pregnant woman of the pros and cons of each strategy. SUMMARY: In HIV-positive men taking HAART, seminal viral load is decreased but not eliminated and fertilization should be achieved through sperm washing to offer maximum protection for the uninfected female. Pregnant HIV-positive women on antiretroviral medication have a reduced risk of transmitting the virus, but should still be counselled about the possibility to further limit the chances of infecting their infant through elective Caesarean section.
Ingsoc - 07 May 2005 05:31 GMT "GMCarter" <fiar@verizon.net> wrote...
> Sperm washing can permit an HIV+ man to impregnate his HIV- partner > and significantly reduce any risk to her or the baby of becoming > infected. Which leads me to ask the question on whether it is ethical to subject any uninfected person to ANY risk of contracting HIV, especially for a non-life-threatening thing like reproduction. A blood tranfusion still carries some risk but it can be argued that saving the life of a patient outweighs that risk. But reproduction is largely voluntary, a person will not die if he/she does not have children. And since the emotional bonds between couples who wish to reproduce are so strong that they could amount to an undue influence and that any consent to accept the risk of contracting HIV through artificial insemination with "washed" sperm amounts to incompetence and should not be allowed. Maybe the risk is only 1%, but do you still have the right to infect your partner and your baby with your nasty plague?
Brian Mailman - 07 May 2005 17:52 GMT > Which leads me to ask the question on whether it is ethical to subject > any uninfected person to ANY risk of contracting HIV, especially for > a non-life-threatening thing like reproduction. ever heard the expression 'died in childbirth/' as well as many laws in several us states that have a clause '...or the life of the mother...' there's a reason they've been used.
also google on 'preeclampsia' with and without a hyphen.
just for a start.
b/
Ingsoc - 07 May 2005 05:24 GMT <ml34b@hotmail.com> wrote in message...
>i don't know how sperm donation works. > is the sperm exposed to open air or do they have [quoted text clipped - 5 lines] > am i correct on this? > thanks for anyones help. Do you even have to ask such a stupid question? First of all, sperm samples are quickly sealed to prevent degeneration, and although some exposure to air is inevitable, virtually all the sperm in the sample are contained within the gob of semen and are thus NOT exposed to airborne oxygen molecules. If the sperm doesn't die, neither does the HIV virus. But yes, I suppose it is possible (though I've never read of any research that proved it) that HIV-infected semen that has dried completely for several hours is probably far less infectious than fresh semen. But would you still touch it?
ml34b@hotmail.com - 08 May 2005 12:36 GMT What is your problem? Don't be a condescending prick. My question is not stupid. I don't know much about hiv. I ask the question hoping the answers will educate all and not just me. I think this is a newsgroup where you need to turn off your arrogance. As hard as it may be for some.
ml34b@hotmail.com - 08 May 2005 12:45 GMT What is your problem? Don't be a condescending prick. My question is not stupid. I don't know much about hiv. I ask the question hoping the answers will educate all and not just me. I think this is a newsgroup where you need to turn off your arrogance. As hard as it may be for some.
ml34b@hotmail.com - 08 May 2005 13:17 GMT > Do you even have to ask such a stupid question? First of all, > sperm samples are quickly sealed to prevent degeneration, and [quoted text clipped - 6 lines] > completely for several hours is probably far less infectious > than fresh semen. But would you still touch it? What is your problem? Don't be a condescending prick. My question is not stupid. I don't know much about hiv. I ask the question hoping the answers will educate all and not just me. I think this is a newsgroup where you need to turn off your arrogance. As hard as it may be for some.
|
|
|