Achieving pregnancy safely

In female-positive HIV-serodiscordant couples desiring children, home timed vaginal insemination (TVI) of semen during the fertile period along with consistent condom use may reduce the risk of HIV transmission when the man is HIV-uninfected. In sub-Saharan Africa, up to 45% of HIV-infected women desire to have more children. HIV viral load assessment is not routinely available in low-resource countries for monitoring adherence and response to antiretroviral therapy. Therefore, in these settings, timed unprotected intercourse without assurance of HIV viral suppression may pose unnecessary risks. TVI, a simple and affordable intervention, can be considered an adjunct method and option of safer conception for HIV prevention with treatment of the HIV-infected partner and/or pre-exposure prophylaxis. We conducted five mixed and single-sex focus group discussions comprised of 33 HIV-serodiscordant couples and health-care providers in the Nyanza region of Kenya to assess the acceptability and feasibility of TVI as a safer method of conception. The transcribed data were analyzed using a grounded theory approach. We found that educating and counseling HIV-serodiscordant couples on TVI could make it an acceptable and feasible safer conception method when associated with frequent communication and home visits by health-care providers. The findings of this study indicate that implementation studies that integrate training and counseling of HIV-serodiscordant couples and health-care providers on TVI combined with consistent condom use are needed. Acknowledging and supporting the reproductive choice and needs of female positive, male negative HIV-serodiscordant couples who desire children should also include the use of assisted reproductive services at the same time as pharmaceutical options that prevent sexual HIV transmission

Antiretroviral therapy · Condom · Environmental health · Family medicine · Gynecology · Health care · Obstetrics · Population · Pregnancy · Reproductive health · Serodiscordant · Viral load · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing

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  Open Access•Sarah A Gutin, Maurine Atieno et al.•AIDS Care•2026

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• Relationship, partner factors and stigma are associated with safer conception information, motivation, and behavioral skills among women living with HIV in Botswana

  Open Access•Sarah A Gutin, G W Harper et al.•BMC Public Health•2021

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• Emtonjeni—A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa

  Open Access•Joanne E Mantell, Diane Cooper et al.•AIDS and Behavior•2016

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• Changes in Providers’ Self-Efficacy and Intentions to Provide Safer Conception Counseling Over 24 Months

  Open Access•Kathy Goggin, Eric A Hurley et al.•AIDS and Behavior•2018

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• Periconception HIV Risk Behavior Among Men and Women Reporting HIV-Serodiscordant Partners in KwaZulu-Natal, South Africa

  Open Access•Lynn T Matthews, Jennifer Smit et al.•AIDS and Behavior•2015

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• Unmet patient needs and information gaps in fertility counseling for persons living with HIV/Aids

  Open Access•Priscilla Asantewaa Boadi, Victor Luckyboy Dzramado et al.•PLOS Global Public Health•2026

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• Preventing HIV and achieving pregnancy among HIV sero-different couples

  Open Access•Joelle Brown, Serah Gitome et al.•PLOS Global Public Health•2023

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• “I don't know if this is right … but this is what I'm offering”

  Nora S West, Nora West et al.•AIDS Care•2016

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• Effectiveness of an HIV-risk reduction intervention to reduce HIV transmission among serodiscordant couples in Durban, South Africa. A randomized controlled trial

  Sibongile Mashaphu, Gail E Wyatt et al.•AIDS Care•2020

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• Application of an ecological framework to examine barriers to the adoption of safer conception strategies by HIV-affected couples

  Haneefa T Saleem, Pamela J Surkan et al.•AIDS Care•2016

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• New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda

  Open Access•Kristin Dunkle, Kristin L Dunkle et al.•The Lancet•2008

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• Factors Associated with Intention to Conceive and its Communication to Providers Among HIV Clients in Uganda

  Open Access•Glenn J Wagner, Glenn Wagner et al.•Maternal and Child Health Journal•2011

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• Life is still going on

  Open Access•Diane Cooper, John Harries et al.•Social Science & Medicine•2007

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