HIV transmission through donor artificial insemination
M. R. Araneta, L. Mascola, A. Eller, L. O'Neil, M. M. Ginsberg, M. Bursaw, J. Marik, S. Friedman, C. A. Sims, M. L. Rekart and al. et
Los Angeles County Department of Health Services, CA.
OBJECTIVE--To investigate and report cases of human immunodeficiency virus
(HIV) transmission through donor artificial insemination (AI) before 1986
at five infertility clinics. DESIGN--Two types of look-back studies were
performed: (1) identification of an HIV-infected woman who reported
previous AI, followed by identification of the infected donor(s) and
contact tracing of women who were inseminated with his semen, and (2)
identification of an HIV-infected donor and subsequent examination of women
receiving AI procedures using his semen. SETTING--Five infertility clinics
in Los Angeles County, California; San Diego County, California; Arizona;
and Vancouver, British Columbia. PATIENTS--A total of 230 women were
inseminated with semen from any one of the five identified HIV-infected
donors; 199 (87%) consented to HIV testing. MAIN OUTCOME
MEASURE--Seropositivity for HIV among AI recipients. RESULTS--Seven (3.52%)
of the 199 women (95% confidence interval, 1.55% to 7.41%) who were
artificially inseminated with semen from any of five HIV-infected donors
and consented to HIV testing tested HIV-seropositive. Information on HIV
risk was available for three of the five donors; all three reported a
history of having sex with men. Four HIV-infected women were identified
through uncommon circumstances, rather than through routine look-back
studies of donors. CONCLUSION--Infection with HIV through donor AI
performed before routine HIV screening of semen donors represents a
potentially serious threat to women who underwent AI procedures. Public
health policies requiring retrospective identification of HIV-infected
semen donors and patients receiving AI before 1986, especially in acquired
immunodeficiency syndrome (AIDS)-prevalent areas, should be considered
routine. Women diagnosed with AIDS or HIV infection, in whom no identified
risk of HIV acquisition is established, should be questioned about previous
AI procedures.
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HIV from Artificial Insemination
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HIV TRANSMISSION VIA SEMEN FROM UNSCREENED DONORS
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