Antiretrovirals and safer conception for HIV-serodiscordant couples

Matthews, Lynn T.a; Smit, Jennifer A.b; Cu-Uvin, Susanc; Cohan, Deborahd

Erratum

There was an error in the appearance of Table 2. Recommendations for mutually disclosed serodiscordant couples who choose to attempt conception through intercourse and have completed baseline fertility and preconception evaluation(s) that appears on page 572 of this paper [1]. The correct version of this table can be found below.

Current Opinion in HIV and AIDS. 8(1):86, January 2013.

Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e328358bac9
PRE-EXPOSURE PROPHYLAXIS: Edited by Kenneth H Mayer
Abstract

Purpose of review: Many men and women living with HIV and their uninfected partners attempt to conceive children. HIV-prevention science can be applied to reduce sexual transmission risk while respecting couples’ reproductive goals. Here we discuss antiretrovirals as prevention in the context of safer conception for HIV-serodiscordant couples.

Recent findings: Antiretroviral therapy (ART) for the infected partner and pre-exposure prophylaxis (PrEP) for the uninfected partner reduce the risk of heterosexual HIV transmission. Several demonstration projects suggest the feasibility and acceptability of antiretroviral (ARV)s as periconception HIV-prevention for HIV-serodiscordant couples. The application of ARVs to periconception risk reduction may be limited by adherence.

Summary: For male-infected (M+F−) couples who cannot access sperm processing and female-infected (F+M−) couples unwilling to carry out insemination without intercourse, ART for the infected partner, PrEP for the uninfected partner, combined with treatment for sexually transmitted infections, sex limited to peak fertility, and medical male circumcision (for F+M couples) provide excellent, well tolerated options for reducing the risk of periconception HIV sexual transmission.

Author Information

aMassachusetts General Hospital, Center for Global Health and Division of Infectious Disease; Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, USA

bDeputy Divisional Head, Maternal, Adolescent and Child Health Division (MatCH), University of the Witwatersrand, Durban, South Africa

cAlpert Medical School at Brown University, Obstetrics and Gynecology and Medicine, Providence

dUniversity of California at San Francisco, Department of Obstetrics, Gynecology and Reproductive Services, San Francisco, USA

Correspondence to Lynn T. Matthews, Assistant in Medicine, Massachusetts General Hospital, Center for Global Health and Division of Infectious Disease; Associate in Medicine, Beth Israel Deaconess Medical Center, Division of Infectious Diseases, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA. E-mail: ltmatthe@bidmc.harvard.edu

© 2012 Lippincott Williams & Wilkins, Inc.