Guideline

Guideline on safer conception in fertile HIV-infected individuals and couples

L-G Bekker, V Black, L Myer, H Rees, D Cooper, S Mall, C Mnyami, F Conradie, I Mahabeer, L Gilbert, S Schwartz
Southern African Journal of HIV Medicine | Vol 12, No 2 | a196 | DOI: https://doi.org/10.4102/sajhivmed.v12i2.196 | © 2011 L-G Bekker, V Black, L Myer, H Rees, D Cooper, S Mall, C Mnyami, F Conradie, I Mahabeer, L Gilbert, S Schwartz | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2011 | Published: 26 May 2011

About the author(s)

L-G Bekker, Desmond Tutu HIV Foundation
V Black,
L Myer,
H Rees,
D Cooper,
S Mall,
C Mnyami,
F Conradie,
I Mahabeer,
L Gilbert,
S Schwartz,

Abstract

Ninety years ago the isolation of insulin transformed the lives of people with type 1 diabetes. Now, models based on empirical data estimate that a 25-year-old person with HIV, when appropriately treated with antiretroviral therapy, can expect to enjoy a median survival of 35 years, remarkably similar to that for someone of the same age with type 1 diabetes. It is high time we normalised the lives of people living positively with HIV. This includes the basic human right to conceive and raise children. HIV-positive individuals may be in serodiscordant relationships or in seroconcordant relationships. As health care providers, it is our responsibility to ensure we understand the opportunities and risks of natural conception in these scenarios, so that we can help our patients to make informed decisions about their own lives. Most of all, it is our duty to make family planning in the setting of positive prevention as safe as we can. This includes informed decisions on contraception, adoption, fostering, conception and prevention of mother-to-child transmission. Some months ago a dedicated group of individuals, invited and sponsored by the Southern African HIV Clinicians Society, came together in Cape Town to devise guidance in this area, recognising that there are ideal strategies that may be outside the realm of the resource constraints of the public sector or health programmes in southern Africa. This guideline therefore attempts to provide a range of strategies for various resource settings. It is up to us, the providers, to familiarise ourselves with the merits/benefits and risks of each, and to then engage patients in meaningful discussions. All the above, however, is based on the premise and prerequisite that the subject of family planning is actively raised and frequently discussed in our patient encounters.

Please find a link to the update of this guideline: http://sajhivmed.org.za/index.php/hivmed/article/view/399


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JAIDS Journal of Acquired Immune Deficiency Syndromes  vol: 67  issue: Supplement 4  first page: S250  year: 2014  
doi: 10.1097/QAI.0000000000000377

59. A Novel Safer Conception Counseling Toolkit for the Prevention of HIV: A Mixed-Methods Evaluation in Kisumu, Kenya
Joelle Brown, Betty Njoroge, Eliud Akama, Brooke Breitnauer, Anna Leddy, Lynae Darbes, Richard Omondi, Okeoma Mmeje
AIDS Education and Prevention  vol: 28  issue: 6  first page: 524  year: 2016  
doi: 10.1521/aeap.2016.28.6.524

60. Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa
Natasha ECG Davies, Lynn T Matthews, Tamaryn L Crankshaw, Di Cooper, Sheree R Schwartz
Journal of the International AIDS Society  vol: 20  first page: 21271  year: 2017  
doi: 10.7448/IAS.20.2.21271

61. Experiences of coercion to sterilize and forced sterilization among women living with HIV in Latin America
Tamil Kendall, Claire Albert
Journal of the International AIDS Society  vol: 18  issue: 1  year: 2015  
doi: 10.7448/IAS.18.1.19462

62. Community perceptions of childbearing and use of safer conception strategies among HIV‐discordant couples in Kisumu, Kenya
Brooke T Breitnauer, Okeoma Mmeje, Betty Njoroge, Lynae A Darbes, Anna Leddy, Joelle Brown
Journal of the International AIDS Society  vol: 18  issue: 1  year: 2015  
doi: 10.7448/IAS.18.1.19972

63. Promoting reproductive options for HIV‐affected couples in sub‐Saharan Africa
O Mmeje, CR Cohen, A Murage, J Ong'ech, J Kiarie, S van der Poel
BJOG: An International Journal of Obstetrics & Gynaecology  vol: 121  issue: s5  first page: 79  year: 2014  
doi: 10.1111/1471-0528.12876

64. Achieving Pregnancy Safely in HIV-Affected Individuals and Couples
Okeoma Mmeje, Betty Njoroge, Craig R. Cohen, Marleen Temmerman, Sten H. Vermund, Sheryl van der Poel
JAIDS Journal of Acquired Immune Deficiency Syndromes  vol: 70  issue: 4  first page: e155  year: 2015  
doi: 10.1097/QAI.0000000000000814

65. Fertility desires of people living with HIV: does the implementation of a sexual and reproductive health and HIV integration model change healthcare providers’ attitudes and clients’ desires?
Cecilia Milford, Mags Beksinska, Ross Greener, Jacqueline Pienaar, Letitia Rambally Greener, Zonke Mabude, Jennifer Smit
BMC Health Services Research  vol: 21  issue: 1  year: 2021  
doi: 10.1186/s12913-021-06487-0

66. Fertility-related research needs among women at the margins
Sheree R Schwartz, Stefan Baral
Reproductive Health Matters  vol: 23  issue: 45  first page: 30  year: 2015  
doi: 10.1016/j.rhm.2015.06.006

67. Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018
Natasha E.C.G. Davies, Gail Ashford, Linda-Gail Bekker, Nomathemba Chandiwana, Diane Cooper, Silker J. Dyer, Lauren Jankelowitz, Otty Mhlongo, Coceka N. Mnyani, Muhangwi B. Mulaudzi, Michelle Moorhouse, Landon Myer, Malika Patel, Melanie Pleaner, Tatiana Ramos, Helen Rees, Sheree Schwartz, Jenni Smit, Doreen S. van Zyl
Southern African Journal of HIV Medicine  vol: 19  issue: 1  year: 2018  
doi: 10.4102/sajhivmed.v19i1.915

68. Societal and individual drivers of fertility desires and intentions among people living with HIV: a cross sectional study of HIV clinic attendees in Soweto, South Africa
Penelope Chirambira, Sphiwe Madiba, Busisiwe Ntuli
AIMS Public Health  vol: 9  issue: 1  first page: 173  year: 2021  
doi: 10.3934/publichealth.2022013