Spain lifts ban and opens doors to organ transplants from HIV+ donors.

The announcement made by the Ministry of Health of Spain, coinciding with World AIDS Day, marks a significant milestone in the evolution of organ transplant regulations. The decision to move forward with the repeal of the ministerial order that, since 1987, prohibited the use of organs from donors with HIV, represents not only an update in health policy but also a paradigm shift in the perception of the disease. This measure follows the global trend of considering HIV as just another virus rather than a stigma, aligning with practices already implemented in other countries where this policy has proven to be safe and effective. Historically, the relationship between HIV/AIDS and organ transplantation has been marked by fear and misinformation. Since the onset of the pandemic in the 1980s, the medical community and society in general reacted cautiously to the virus, leading to the implementation of restrictive criteria that often resulted in the exclusion of potential donors. These criteria, which included disqualifying homosexual individuals or those with a history of intravenous drug use, reflected a context in which knowledge about HIV was limited and fear of transmission was palpable. The 1987 ministerial order, although based on the knowledge of the time, became an obstacle to progress in organ donation from HIV-positive individuals. While other viruses have seen a more flexible approach in their treatment, the regulations surrounding HIV remained rigid, making it difficult to use organs from donors carrying the virus. This not only limited transplant options but also perpetuated a stigma that has accompanied the population affected by HIV for decades. With advancements in antiretroviral therapies and increased understanding of HIV, transplants in HIV-positive patients began to take place in other countries in the late 1990s. In Spain, the first kidney transplant in an HIV+ individual was carried out in 2001, paving the way for a series of interventions that progressively normalized this practice. In this regard, the recognition that HIV-positive patients can be organ recipients has evolved, allowing for more than 800 people to have received transplants since then. In recent years, international experience has validated the safety of organ transplants from HIV+ donors. Findings from studies conducted in the United States and South Africa demonstrate that outcomes are comparable between HIV+ and HIV- organ recipients, leading to greater acceptance of this practice in various nations. However, Spain had remained on the margins of this trend, which is now beginning to change with the proposal to repeal the restrictive regulations. Recent studies estimate that in the last decade, numerous donors were rejected for being carriers of the virus, potentially depriving many patients of the chance to receive a transplant. From now on, with the new regulations on the way, it is expected that more HIV+ donors will be able to contribute to saving lives. Although the numbers of transplants resulting from this measure may not be overwhelming, each intervention represents a valuable opportunity for those in need. Estimates suggest that a limited number of HIV+ donors would contribute to an even more restricted number of transplants. However, the importance of this decision lies in its symbolic value and its contribution to the normalization of HIV in society. The ONT emphasizes that donation should be considered a right and a valid option for all, regardless of their serological status. Finally, this decision not only has practical implications in the health sector, but also represents an important change in the social perception of HIV. The removal of legal barriers that restrict organ donation by HIV-positive individuals is a step toward destigmatizing the disease and recognizing the dignity and rights of all people, regardless of their health condition. Thus, Spain moves toward a new era in organ donation, where ethics, science, and humanity intertwine to offer a chance at life to those who need it most, reaffirming that solidarity and generosity know no boundaries.