From root@aspensys.com Wed Jun 21 14:14:53 1995 Date: Wed, 21 Jun 1995 17:28:58 +0500 CENTERS FOR DISEASE CONTROL AND PREVENTION HIV/AIDS PREVENTION CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN ................................................................. June 14, 1995 #143 This is the answer from the Centers for Disease Control and Prevention (CDC) to a question submitted by the CDC National AIDS Hotline concerning sperm washing. Does sperm washing reduce or eliminate the risk of HIV transmission via artificial insemination when the donor is known to be HIV-infected? How is it done? Is it legal in the United States? If not, where is it done? There is no demonstrably effective way to process semen so that HIV will always be separated from sperm. CDC has documented an instance of HIV transmission through the use of processed semen (1). The processing technique described in reference 1 and elsewhere is inconsistently used but essentially 'washes' semen by repeatedly centrifuging (spinning) it in a special solution that separates the heavier elements (sperm) from other elements found in semen. There are many scientific controversies regarding such processing techniques. One of these concerns is that HIV adheres to sperm cells and may not be capable of being completely removed by any semen 'washing' procedure. Another concern is that processed semen is often inseminated into the cervical canal where it will directly contact endometrium. It is unknown whether this route carries a greater risk of HIV infection than that of vaginal insemination or vaginal intercourse. In short, there is no method or combination of methods of insemination that has been shown to eliminate or even reduce the risk of HIV infection to the woman. Recipients of any processed semen should be aware that they may be at risk of transmission of HIV. All donors of semen and other tissues should be tested for the presence of HIV antibody. These recommendations are discussed in more detail in references 2 and 3. Organizations such as the American Medical Association, the American Association of Tissue Banks, the American Fertility Society, and the American College of Obstetricians and Gynecologists follow identical or similar recommendations. Some states have enacted legislation regarding the use of any reproductive tissue. Persons who are considering this procedure should contact their physician, public health department, or the organizations listed above. References: 1. CDC. HIV-1 infection and artificial insemination with processed semen. MMWR 1990;39:249,255-6. 2. CDC. Semen banking, organ and tissue transplantation, and HIV antibody testing. MMWR 1988;37:57-58, 63. 3. CDC. Guidelines for preventing transmission of HIV through transplantation of human tissue and organs. MMWR 1994;43:RR-8. Disclaimer: CDC Hotline Training Bulletins The information in the "CDC Hotline Training Bulletins" is provided by CDC and NIH for use by the CDC National AIDS Hotline in responding to general questions from the public about HIV and AIDS. The bulletins are not intended to be comprehensive discussions of the subject areas. Treatment and drug therapy options change as new research and clinical experiences broaden scientific knowledge. Therefore, persons seeking information on drug therapy should refer to the product information sheet included in all drug packages for the most current and accurate information about a particular drug, especially if the drug is new or infrequently used. HIV-infected individuals should consult their personal physician for specific concerns about their health. For persons desiring more information on a specific topic, public, medical, and university libraries can provide excellent references. The AIDS Clinical Trials Information Service (800-874-2572) can provide information about ongoing HIV/AIDS clinical trials; the HIV/AIDS Treatment Information Service (800-448-0440) can assist with information about the latest treatments for persons with HIV infection or AIDS.