Olivia and Amy are sitting outside in the shade, trying to escape from New Zealand’s early-summer humidity. Amy, 10 months old, burbles happily in the background as her mother talks. She is healthy, happy, and oblivious to her status as a world first: one of a handful of babies born from the first sperm bank for HIV-positive donors.
The bank, Sperm Positive, launched in New Zealand in 2019, in an effort to reduce the stigma faced by HIV-positive people – and raise awareness that with treatment, the virus was undetectable and untransmissible. It grabbed international headlines when it was launched, but has been more than a publicity gimmick. Two years on, the bank is bearing fruit.
“For me, it wasn’t about that,” Olivia says, referring to the more controversial implications of the sperm bank’s launch. “For me, I just wanted to have a baby …. [and] she is just the cheekiest, happiest, funniest little girl.”
Victor, one of the bank’s donors, had thought having a child would be impossible for him. “When I was diagnosed back in 2013, I felt that something like this could never happen – that I was ever going to be able to have children,” he says. On hearing about the bank, “I saw this opportunity – one, to give the opportunity to the couple … to have a child and to make their dreams come true. And second, to prove to myself by evidence that actually it is possible, regardless of your status.” After facilitating two successful pregnancies as a donor, he and his partner are now seeking a surrogate, to try to have a child of their own.
The online sperm bank matches prospective parents with donors, and was set up as a collaboration between New Zealand Aids Foundation, Positive Woman Inc and Body Positive. Jane Bruning of Positive Women Inc says since launching two years ago the organisation had “been overwhelmed by the number of inquiries we have received from people keen to receive more information”.
Developed partly as an awareness project, it aims to try to drive home the “undetectable = untransmissible” message: that as HIV treatments reduce viral levels in the blood to undetectable, positive people are no longer at risk of transmitting it to healthy partners.
The finding “has been shown again and again for over 10 years now,” says Dr Mark Thomas, an associate professor at University of Auckland and HIV-specialised infectious disease doctor at Auckland district health board. Three large, long-term multinational studies have followed about 3,000 sexually active mixed HIV-status couples over years while they did not use condoms, and did not find a single case of transmission when the man was using suppression medication.
Despite this, some countries are still cautious about reproductive advice for HIV-positive men – the CDC’s advice as of 2017 was to consider use of PrEP and ‘sperm washing’ in addition to suppressive medications. Thomas says that reflects an abundance of caution, rather than a real risk that a father could infect the child. There has never been a confirmed case of an HIV-positive child being infected via the father’s sperm and born to an HIV-negative mother, he says.
Thomas says while the sperm bank has grabbed headlines, the deeper and more ongoing story is that those who test positive still often experience stigma and discrimination – in housing, employment, medical treatment, and from their families or communities.
In the early days of the epidemic, when it principally effected gay men, “It was one stigma on top of another,” says Thomas, who first began treating HIV and Aids patients at Auckland hospital in the 1980s. “Back in the 80s and the first half of the 90s, it was a close to universally-fatal diagnosis. So sex and death and homosexuality mixed in together [to create] a really terrible stigma.” While it’s improved since then, social attitudes still don’t reflect the enormous leaps forward in HIV treatment: today, “with maybe one pill at night or a couple of pills a day … HIV never impacts on their life again, medically.”
Fear of that stigma is still strong for some of the bank’s donors, including Victor. “In regards to my status, I am still very much in the closet – it’s not something you’re shouting to the four winds,” he says. He has disclosed only to his partner and a handful of close friends. “Sometimes I get my days where I’m just thinking, I have really, really just messed up. It’s not something that I have that I [can] be proud of – but I have learned to live with it and just to keep it to myself.”
New Zealand’s University of Otago-run People Living with HIV Stigma Index conducted interviews with 188 HIV-positive New Zealanders last year. Despite all participants being on antiretroviral treatments, a third reported experiencing social stigma related to their status – including gossip, cruel remarks, and verbal harassment. More than half reported stigma in healthcare settings. Some reported losing employment, and more than half had experienced depression, anxiety and insomnia in the last year.
“When my parents discovered I had HIV they were actively wanting me to use separate dishes, to use ‘tongs’ when I handle food in the kitchen. It made me feel really dirty, and very low,” one 27-year-old told the study. After disclosing to a landlord that she and her partner were HIV positive, “We were given notice to leave the flat,” one woman said.
“When I have disclosed my positive HIV status to guys I have dated, I would either never hear from them again or they would block me from social media apps,” another man reported.
“I’m afraid of being rejected,” Victor says – but the children he has helped create have been a bright spot. On the news that another couple’s baby had been safely born, he says, he felt a wave of joy. “It was so much happiness – to be able to see something that you never thought was going to be possible. And just to see, hear how much joy this new little being has brought to the family to the couple that I help with. Beautiful, really.”
The names of sperm donors, children and mothers have been changed to protect the identity of donors that have not publicly disclosed their HIV status.