The adverse effects that the human immunodeficiency virus (HIV) can have on the health of sick people have been the subject of characterization and exclusion of patients as well as carriers for many decades. Thanks to advances in science, people living with HIV now have a normal life expectancy. By 2021, the number of reported cases in Europe was 2.34 million, while worldwide the number of people on antiretroviral treatment is estimated at about 22 million. In our country, the number of diagnosed persons who are carriers of the human immunodeficiency virus is estimated at about 18 thousand people.

Recent medical evidence clearly shows that conception, whether through natural conception or medically assisted reproduction, does not carry the risk of HIV transmission if the person is receiving effective medication. However, despite ever-increasing and well-documented scientific evidence, opportunities for people living with HIV who want to become parents are still severely limited, and the social structure has not kept pace with science. From a medical point of view, couples in which both or only one partner is HIV positive should not be prevented from trying to have a child through natural conception, nor should they be prevented from using assisted reproductive therapies if necessary. So far, the only restriction for these persons is the transfer of reproductive material to third parties.

In 11 European countries, as well as in countries such as Israel, Australia and the United States, both public and private assisted reproduction centers operate exclusively to serve HIV-positive people. In most of the countries mentioned above, IVF is subsidized by the state. In both the US and Europe, there have been thousands of births to HIV-positive women who have undergone assisted reproduction techniques with successful pregnancies and no transmission of the virus to children. Also, according to the recommendations of the European Organization for Human Reproduction and Embryology (ESHRE), HIV-positive people are not excluded from assisted reproduction, but for safety reasons they either have to go to specialized IVF centers designed only for such cases, or they can go to any institution. assisted reproduction, but will need to be serviced at a time when the facility stops normal operations and services for HIV-negative people to treat HIV-positive couples. In this case, appropriate disinfection will follow, after which the operation of the unit for non-HIV-positive people will resume.

However, the complete absence of a special Department for these people in our country practically closes the door to assisted reproduction, because public and private departments do not stop their work to serve HIV-positive people, as a result of which every dream of these couples comes true. refuse to have children, contributing to their marginalization. Today, in our country, HIV-positive people with infertility problems are practically forbidden to have children by assisted reproduction. And this is confirmed by the fact that no license has yet been issued by the National Medically Assisted Reproduction Authority (EAIYA). According to official EODY data, in 2020 alone, 601 new cases of HIV were diagnosed and reported, of which 482 were men and 119 were women. The number of HIV-positive persons registered between 1981 and 2020 in Greece is approximately 18,000 cases, with the majority of cases diagnosed between the ages of 30 and 39, and these people are considered to be of basic reproductive potential.

The National Office of Assisted Reproduction from a medical point of view as an assistant to those who are being assisted, and after ascertaining the needs of people living with the AIDS virus, in 2022 recommended that the Ministry of Health establish a state office of assisted reproduction exclusively for HIV. positive people. In fact, EAIYA for the first time in our country offered equal treatment to this category of citizens in terms of the right to reproduce. The Government and the Ministry of Health have warmly welcomed this proposal made by me in my capacity as Chairman of the National Authority for Medically Assisted Reproduction. Prime Minister Mr. K. Mitsotakis and Minister of Health Mr. A. Pleuris introduced a new law, passed by Parliament this summer, designed to change the situation in the field of assisted reproduction of HIV-positive people. .

In the context of the new law 4958/2022 (Government Gazette A’ 142/21-07-2022), the establishment of a public department of medically assisted reproduction for HIV-positive people at the Attikon University General Hospital was announced. Attikon Hospital already has an EAIYA-licensed Assisted Reproduction Department and a Cryopreservation Bank at the 3rd University of Athens Obstetrics and Gynecology Clinic. Also, Attikon has one of the largest and most prominent groups of infectious disease specialists in our country, as well as the Department of Special Infections of the 4th Pathological Anatomical Department, who have experience in monitoring HIV-positive individuals and could effectively assist in their management. Thus, the cooperation of two clinics and departments can bring maximum benefit in providing assistance and services to these people. Spatially, Attikon is one of the largest hospitals in Attica, and it is critical to find a location for the installation of the new Medical Assisted Reproduction Unit and Cryopreservation Bank, which should operate in separate rooms from the existing Medical Assisted Reproduction Unit and Cryopreservation Bank. necessity.

With the launch of the new department at Attica Hospital, couples wishing to have a baby will be able to apply for and receive special approval from the National Authority for Medically Assisted Reproduction, and six applications have already been submitted from HIV positive individuals. To the national authority after the publication of law 4958/22. Available data show that HIV-positive women who receive appropriate treatment that suppresses the virus to undetectable levels have little or no chance of transmitting the virus to their newborn at birth. The same studies also show that people with HIV whose viral load is not detectable after treatment may even safely become sperm or egg donors, as the risk of transmission is zero, which is still being studied and not practiced.

At this stage, and after the government has announced the legal establishment of this dedicated assisted reproduction unit for HIV positive people, it is important to prioritize its construction, staffing, operation and equipment. It is necessary to find the necessary funds or seek appropriate sponsorship as soon as possible, as well as overcome any problems that delay the material implementation of the creation of the Unit for HIV-positive people, so that this progressive idea of ​​u200bu200bpublic health planning does not remain, Ministry of Health, but also EAIYA, an empty letter .

As President of the National Authority for Medically Assisted Reproduction, I invite all of you to help each of us create a Medically Assisted Reproduction Unit for HIV positive people as a sign of empathy and social solidarity. A step forward towards truly understanding the needs of HIV positive people who feel marginalized by HIV. Assist them in equal treatment in health care and in particular in their access to assisted reproduction from a medical point of view, giving meaning to Articles 4 and 21 of the Constitution.

*Nikolaos Vrachnis is President of the National Board of Medically Assisted Reproduction and Associate Professor at the Department of Obstetrics and Gynecology at the EKPA School of Medicine.