Fertility Care for HIV Serodiscordant Couples Is More Widely Available

A survey to be published in Fertility and Sterility shows that fertility services for HIV serodiscordant couples in the United States are much more widely available than previously thought, but that it is easier for physicians to obtain services for their patients than for patients seeking services to obtain them for themselves.

In a two-arm, cross-sectional secret shopper study, researchers contacted 140 assisted reproductive technology clinics selected from the SART membership in the 15 states with the highest prevalence of HIV among heterosexuals. On the telephone, they presented themselves as either the 30-year-old female partner of an HIV-infected male, or as a physician making inquiries on behalf of this patient.

The researchers spoke with someone at 90% of the clinics, but whether they were told the clinic could offer services or not depended on whether the caller presented as a physician or a patient.

When a physician called, 63% of the time they were told that the clinic could offer services; patients who called were only offered services 40% of the time. Of the 55 clinics that were not able to provide fertility services to serodiscordant couples, 51% were able to refer callers to another clinic they were confident could offer the services.

Whether or not the caller received information on services for serodiscordant couples also had to do with who they reached at the clinic. Conversation with clinical staff- physicians, nurses, physician’s assistants, and nurse practitioners- was more likely to result in an offer of available services or a referral than was contact with a scheduler or receptionist.

ASRM President Christos Coutifaris, MD, PhD commented, “While we’ve made great progress in the last decade increasing the number of ART clinics able to treat HIV serodiscordant couples, barriers remain. The information one receives concerning these services should not depend upon one’s status as a patient or physician, or who they speak with at the clinic. Increasing provider and staff awareness and education about the availability of fertility services for HIV patients will improve access as well as outcomes for these couples and their children.”

Leech et al, Assessing Access to Assisted Reproductive Services for HIV Serodiscordant Couples, Fertility and Sterility, in press.


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Sean Tipton
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Eleanor Nicoll
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