Pre-exposure prophylaxis and timed intercourse for HIV-discordant couples willing to conceive a child
Objectives: To reduce risk-taking behavior in HIV-discordant couples (male HIV-pos.) willing to conceive a child.
Methods: HIV-discordant couples expressing the desire to conceive a child received a standardized risk reduction counseling including LH-peak measurement and pre-exposure prophylaxis with tenofovir 36 and 12 h before intercourse. Couples were either included after having previously been counseled for artificial insemination with processed semen and quit the program for any reason or after referral through their HIV-physician.
Results: Twenty-two couples were admitted for risk reduction counseling. All male partners have been under a fully suppressive antiretroviral treatment. Six couples admitted that they had previously tried to conceive by unprotected intercourse. Twenty-one couples decided to use the proposed risk reduction strategy with timed intercourse and TDF-pre-exposure-prophylaxis. Pregnancy rates were high with more than 50% pregnancies achieved after 3 cycles (11/21). In 15/21 female partners got pregnant after up to 10 attempts. All women tested negative for HIV-antibodies 3 months after the last exposure.
[Pregnancy rates with natural conception]
Conclusions: The true number of HIV-discordant couples who practice unprotected sex to conceive is most likely underestimated. The risk of transmission in a couple with a fully treated male partner is low and can further be reduced by timed intercourse and a short pre-exposure prophylaxis with tenofovir. The pregnancy rates of natural conception are substantially higher than with artificial reproduction techniques (40% in our program).
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
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Pre-exposure prophylaxis and timed intercourse for HIV-discordant couples willing to conceive a child.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention: