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Access to fertility services in Canada for HIV-positive individuals and couples: a comparison between 2007 and 2014

机译：获得加拿大艾滋病毒阳性个人和夫妻的生育服务：2007年至2014年的比较

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摘要

In the modern era of HIV care, a multitude of clinical needs have emerged; one such need is the growing sub-specialty of HIV and reproductive health. In 2007, a study surveying Canadian fertility clinics found limited access to fertility services for HIV-positive patients. Given the extensive efforts made to address this lack of services, a follow-up assessment was warranted. This study aimed to compare the access to Canadian fertility clinics and services for HIV-positive individuals and couples in 2014 and 2007. Surveys were sent to medical or laboratory directors of assisted reproductive technology (ART) clinics in 2014 and results were compared to those sent in 2007. Main outcome measures included: the proportion of fertility clinics willing to provide ART to people with HIV, the specific services offered, and whether the 2012 Canadian HIV Pregnancy Planning Guidelines were implemented to inform practice. Across Canadian provinces, 20/34 (59%) clinics completed the survey. Ninety-five percent (19/20) of clinics accepted HIV-positive patients for consultation. Only 50% (10/20) of clinics in four provinces offered a full range of ART (defined as including in vitro fertilization [IVF]). Ten clinics (50%) in five provinces were aware that guidelines exist; half (n=5) having read them and four reporting implementation of all the guidelines' recommendations in their practice. Compared to 2007, more clinics had implemented separate facilities (p=0.028) to treat HIV-positive individuals, offered IVF (p=0.013) for HIV-positive female partners, sperm washing (p=0.033) for HIV-positive male partners, and risk reduction techniques to couples with HIV-positive men and women (p=0.006). Access to fertility clinics for people with HIV has improved over time but is still regionally dependent and access to full ART remains limited. These findings suggest the need for advocacy targeted towards geographical-specific areas and optimizing access to comprehensive services.
机译：在现代艾滋病毒护理时代，已经出现了多种临床需求;一种这种需求是艾滋病毒和生殖健康的生长次级专业。 2007年，调查加拿大生育诊所的研究发现，对艾滋病毒阳性患者的生育服务有限。鉴于为解决这种缺乏服务而进行的广泛努力，有权进行后续评估。本研究旨在比较2014年和2007年对艾滋病毒阳性个体和夫妻的加拿大生育诊所和服务的进入。2014年助攻生殖技术（Art）诊所的医疗或实验室董事发送了调查，并将结果与​​发送的结果进行了比较2007年。包括主要成果措施：愿意为艾滋病病毒疫情，提供的具体服务为人民提供艺术的生育诊所的比例，以及2012年加拿大艾滋病毒妊娠计划指南是否被实施以告知实践。跨加拿大省，20/34（59％）诊所完成了调查。诊所九十五（19/20）接受艾滋病毒阳性患者进行咨询。四个省份只有50％（10/20/20）的诊所提供了全面的艺术品（定义包括体外施肥[IVF]）。五个省份十（50％）意识到存在指导方针;一半（n = 5）已阅读他们，并在其实践中读取了四次报告的所有指导方面的建议。与2007年相比，更多的诊所已经实施了单独的设施（p = 0.028），以治疗艾滋病毒阳性个体，为艾滋病毒阳性女性合作伙伴提供IVF（p = 0.013），艾滋病毒阳性男性合作伙伴的精子洗涤（p = 0.033），与艾滋病毒阳性男性和女性的夫妇减少技术（p = 0.006）。随着时间的推移，获得艾滋病毒患者的生育诊所，但仍然是区域依赖，并且获得全面艺术仍然有限。这些调查结果表明，倡导针对地理特定领域的宣传，并优化对全面服务的访问。

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