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4th International AIDS Society Conference on HIV Pathogenesis and TreatmentSydney, Australia - July 22 - 25, 2007 |
PRE-EXPOSURE PROPHYLAXIS AND TIMED INTERCOURSE FOR HIV-DISCORDANT COUPLES WILLING TO CONCEIVE A CHILD
IAS Conf HIV Pathog Treat 2007 Jul 22-25;4th: Abstract No. MOPDC01
Vernazza P.1, Brenner I.1, Graf I.2
1Cantonal Hospital St. Gallen, Department of Medicine, St. Gallen, Switzerland, 2Cantonal Hospital St. Gallen, Department of Social Work, St. Gallen, Switzerland
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).
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2007-07-22
MOPDC01
The Treatment-Prevention Nexus
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