TY - JOUR T1 - View 1: Assisted conception in couples with HIV infection JF - Sexually Transmitted Infections JO - Sex Transm Infect SP - 185 LP - 188 DO - 10.1136/sti.79.3.185 VL - 79 IS - 3 AU - S Sharma AU - C Gilling-Smith AU - A E Semprini AU - S E Barton AU - J R Smith Y1 - 2003/06/01 UR - http://sti.bmj.com/content/79/3/185.abstract N2 - Infertility centres are increasingly dealing with couples with HIV who strongly want to be parents.1 Preconceptional counselling and reproductive assistance for such couples have significant ethical and practical implications for the couple and the carers. This article addresses the ethical and practical issues concerned in assisting them to limit negative consequences, both for the couples and the future child.In general, there are four underlying principles that constitute the framework of medical ethics: Primum non nocere: first of all, do no harm Beneficence: do good Autonomy: respect the individual Justice: honest and fair care. Thus, these principles of medical ethics stress the need to do as much good as possible while keeping the harm/risks of any intervention to the minimum. To respect the patient’s autonomy, they need to be informed of the diagnosis and management options (pros and cons) in terms they understand and be allowed to make choices for their care without undue pressures from carers. Finally, the treatment must be administered in a just and fair manner.2We present three clinical scenarios of couples demonstrating the dilemmas faced in the management of these situations. The man is infected with HIV and the woman is not The woman is infected with HIV and the man is not Both the man and the woman are infected. When these couples are fertile (for example, they have conceived spontaneously in the past) medical intervention aims at reducing the risk of viral transfer to the uninfected partner and the future child. This does not pose a substantial ethical problem, although those against these couples conceiving can argue that providing preconception counselling may encourage them to conceive, thus posing a risk for the uninfected partner and/or the child and that this risk would not be present otherwise.In couples who have already … ER -