Two couples. One virus. A dream of family.
Meet Dan Hartmann and Susan Slingluff Hartmann: High-school buddies. Prom dates. Pregnancy pioneers.
When Dan asked Susan to the prom in the early 1990s, it was as friends. But when the pair reconnected one night over the phone in 2001, it quickly became something more.
"I was excited to hear from him," Susan told me. "I was also thrilled that he was still alive."
Dan, you see, has HIV. He's one of those children who contracted HIV from a blood transfusion (Dan has hemophilia) in the early days of the virus. Susan remembers sitting in the auditorium when Dan told the entire school he had the virus.
When the couple became serious, Susan dug in to one of the big questions for any couple: Could they have a baby--and how? The answer for the Hartmanns took many years, lots of research and eventually to the decision to throw the condoms away for some very carefully planned unprotected sex.
Their daughter, Ryan Nicole Hartmann, was born in 2009.
Meet Poppy and Ted Morgan: A Midwest girl. A tall, sandy-haired Californian. A secret virus. A longed-for family.
When Poppy arrived in San Francisco for her first day on the job, she wasn't thinking of falling in love. But then Ted, who asked for the family's name to be changed because he's not out to everyone about having HIV, opened the door to the building where Poppy was starting her job, and everything changed.
"This is the guy," Poppy remembered thinking. "I just knew it from the moment I met him."
The rest of their relationship wouldn't be so easy, however. It took a few years before the pair started dating, and even longer to conceive their longed-for daughter, nicknamed Pom-Pom.
Along the way, the couple faced down stigma--Ted's own internalized HIV stigma that keeps him in the HIV closet; Poppy's parents' stigma that left her estranged from her parents for years; and medical stigma, that delayed her ability to get the help she needed to have the daughter she dreamed of, one with her husband's sandy hair and lanky build.
"I realize it is a radical decision, and not one that should be made lightly," Poppy wrote on her blog, HIV-Negative Spouses.
"But after eight years of dead ends... it's time to get radical and think outside the box... Beyond the statistics, beyond the policies, beyond the medical offices, and beyond the fear."
"If any of you readers are doctors, policy makers, elected officials... Please," she concluded. "Let me take a risk."
Meet Drs. Myron Cohen and Pietro Vernazza. Infectious disease specialists. Colleagues. Scientific detectives.
"Pietro will tell you that he knew what the results of my study would be," Dr. Myron Cohen, chief investigator of a study that spanned continents to figure out whether treating people with HIV could prevent the spread of the virus, told me. "But I didn't know. How is it that he could know the results of my study when I didn't?"
In the more than 14 years since Vernazza studied under Cohen at the University of North Carolina, the two investigators have gone radically different directions, but with similar results.
Vernazza, an Italian by birth, landed at the Swiss Commission on AIDS-Related Issues (now the Swiss Federal Commission on Sexual Health), and worked directly with HIV-positive patients and couples affected by HIV that wanted to conceive children. Over the years, his counseling moved from offering only the standard protocol, which sought to wipe the HIV virus from semen before using it for assistive reproduction techniques to aid conception, to also offering couples the option of having the negative partner take HIV medicines to prevent transmission. Eventually he also offered a totally unaided option of carefully timed unprotected sex.
None of his couples have transmitted the virus.
"To me, this is a question of punishment," Vernazza told me. "We don't tell people who have hepatitis C that they can never have sex without a condom again, but we do with HIV. It's an attitude that says, 'You have this horrible thing, and you must keep it for yourself.'"
Vernazza was widely vilified for his Swiss Statement, advising that men who meet certain requirements need not use condoms at all. Meanwhile, Cohen's research was lauded as the breakthrough of the year in 2010, and advocates announced that they were holding out hope for an AIDS-free generation.