Abstract
HIV-serodiscordant couples face complicated choices between fulfilling reproductive desire and risking HIV transmission to their partners and children. Sexual HIV transmission can be dramatically reduced through artificial insemination and sperm washing; however, most couples cannot access these resources. We propose that periconception pre-exposure prophylaxis (PrEP) could offer an important, complementary therapy to harm reduction counseling programs that aim to decrease HIV transmission for couples who choose to conceive.In this paper, we describe the potential benefits of periconception PrEP and define critical points of clarification prior to implementation of PrEP as part of a reproductive health program. We consider sexual transmission risk, current risk reduction options, PrEP efficacy, cost, adherence, resistance, fetal toxicity, and impact of PrEP counseling on entry into health services. We address PrEP in the context of other periconception HIV-prevention strategies, including antiretroviral treatment of the HIV-infected partner. We conclude that, should PrEP prove safe and efficacious in ongoing trials, periconception PrEP may offer a useful approach to minimize risk of HIV transmission for individuals of reproductive age in HIV-endemic countries.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1975-1982 |
| Number of pages | 8 |
| Journal | AIDS |
| Volume | 24 |
| Issue number | 13 |
| DOIs |
|
| State | Published - Aug 24 2010 |
| Externally published | Yes |
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Keywords
- antiretroviral prophylaxis
- fertility
- HIV
- HIV prevention
- HIV transmission
- reproduction
- serodiscordant couples
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases
Cite this
Periconception pre-exposure prophylaxis to prevent HIV transmission : Benefits, risks, and challenges to implementation. / Matthews, Lynn T.; Baeten, Jared M.; Celum, Connie; Bangsberg, David.
In: AIDS, Vol. 24, No. 13, 24.08.2010, p. 1975-1982.Research output: Contribution to journal › Comment/debate
}
TY - JOUR
T1 - Periconception pre-exposure prophylaxis to prevent HIV transmission
T2 - Benefits, risks, and challenges to implementation
AU - Matthews, Lynn T.
AU - Baeten, Jared M.
AU - Celum, Connie
AU - Bangsberg, David
PY - 2010/8/24
Y1 - 2010/8/24
N2 - HIV-serodiscordant couples face complicated choices between fulfilling reproductive desire and risking HIV transmission to their partners and children. Sexual HIV transmission can be dramatically reduced through artificial insemination and sperm washing; however, most couples cannot access these resources. We propose that periconception pre-exposure prophylaxis (PrEP) could offer an important, complementary therapy to harm reduction counseling programs that aim to decrease HIV transmission for couples who choose to conceive.In this paper, we describe the potential benefits of periconception PrEP and define critical points of clarification prior to implementation of PrEP as part of a reproductive health program. We consider sexual transmission risk, current risk reduction options, PrEP efficacy, cost, adherence, resistance, fetal toxicity, and impact of PrEP counseling on entry into health services. We address PrEP in the context of other periconception HIV-prevention strategies, including antiretroviral treatment of the HIV-infected partner. We conclude that, should PrEP prove safe and efficacious in ongoing trials, periconception PrEP may offer a useful approach to minimize risk of HIV transmission for individuals of reproductive age in HIV-endemic countries.
AB - HIV-serodiscordant couples face complicated choices between fulfilling reproductive desire and risking HIV transmission to their partners and children. Sexual HIV transmission can be dramatically reduced through artificial insemination and sperm washing; however, most couples cannot access these resources. We propose that periconception pre-exposure prophylaxis (PrEP) could offer an important, complementary therapy to harm reduction counseling programs that aim to decrease HIV transmission for couples who choose to conceive.In this paper, we describe the potential benefits of periconception PrEP and define critical points of clarification prior to implementation of PrEP as part of a reproductive health program. We consider sexual transmission risk, current risk reduction options, PrEP efficacy, cost, adherence, resistance, fetal toxicity, and impact of PrEP counseling on entry into health services. We address PrEP in the context of other periconception HIV-prevention strategies, including antiretroviral treatment of the HIV-infected partner. We conclude that, should PrEP prove safe and efficacious in ongoing trials, periconception PrEP may offer a useful approach to minimize risk of HIV transmission for individuals of reproductive age in HIV-endemic countries.
KW - antiretroviral prophylaxis
KW - fertility
KW - HIV
KW - HIV prevention
KW - HIV transmission
KW - reproduction
KW - serodiscordant couples
UR - http://www.scopus.com/inward/record.url?scp=77955349669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955349669&partnerID=8YFLogxK
U2 - 10.1097/QAD.0b013e32833bedeb
DO - 10.1097/QAD.0b013e32833bedeb
M3 - Comment/debate
C2 - 20679759
AN - SCOPUS:77955349669
VL - 24
SP - 1975
EP - 1982
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 13
ER -