Preventing HIV and achieving pregnancy among HIV sero-different couples: Pilot study of a safer conception intervention in Zimbabwe

作者：Joelle Brown, Serah Gitome, Bismark Mataveke, Thandiwe Chirenda, Allen Matubu, Gift Chareka, Charles Chasakara, Nyaradzo Mgodi, Caroline Murombedzi, Petina Musara, Tinei Makurumure, Carolyn Smith Hughes, Elizabeth A. Bukusi, Craig R. Cohen, Stephen Shiboski, Lynae A. Darbes, James G. Kahn, George W. Rutherford, Zvavahera M. Chirenje, Felix Mhlanga · 发表于：PLOS Global Public Health · 年份：2023 · DOI：10.1371/journal.pgph.0000796 · 被引用次数：14 · 研究领域：HIV/AIDS Research and Interventions、Adolescent Sexual and Reproductive Health、Sex work and related issues

Safer conception services are needed to minimize HIV transmission among HIV sero-different couples desiring pregnancy. Few studies have evaluated the choices couples make when offered multiple safer conception methods or real-world method acceptability and effectiveness. We piloted a comprehensive safer conception program (Clintrials.gov identifier: NCT03049176) for HIV sero-different couples planning pregnancy in Zimbabwe to measure feasibility, method uptake, acceptability, pregnancy outcome, and HIV transmission. This study was not designed to compare rates of HIV transmission by safer conception method choice but rather to understand choices couples make when seeking to minimize risk of HIV transmission and maximize likelihood of pregnancy. Couples in this prospective, non-randomized study were given a choice of one or more currently available safer conception methods: antiretroviral therapy (ART) with monthly viral load (VL) monitoring for the HIV-positive partner (ART/VL), pre-exposure prophylaxis (PrEP) for the HIV-negative partner, vaginal insemination (VI) for couples with an HIV-positive woman, and semen washing (SW) for couples with an HIV-positive man. Couples were followed monthly for up to 12 months of pregnancy attempts, quarterly during pregnancy, and 12 weeks post-partum. At each visit, data on method use, urine for pregnancy testing, and blood for HIV antibody testing, or viral load if HIV-positive, were obtained. Infants born to HIV-positive women were test...