Nav: Home

Supporting HIV-affected couples trying to conceive

April 04, 2019

ANN ARBOR, Mich. - Women with HIV were once advised against having children for fear that the infection could be passed on to their babies.

But medical advancements are not only allowing people with HIV to live longer and fuller lives -- but to grow their families, too.

Timed vaginal insemination is a safe, effective way to help HIV-affected couples conceive, finds a new pilot study in Kenya led by a Michigan Medicine researcher and published in the PLOS ONE.

Among 23 couples, in which the woman was HIV-positive and the man was not, timed vaginal insemination led to six live births without a case of HIV transmission.

"People who are living with a stable HIV infection are focused on fully integrating into their communities and living productive lives," says lead author Okeoma Mmeje, M.D., assistant professor of obstetrics and gynecology at Michigan Medicine. Mmeje conducted the study while at the University of California, San Francisco.

"HIV does not change an individual's desire to have children," she says. "Our study describes a feasible, safe and effective method for women living with HIV to achieve pregnancy."

HIV-serodiscordant

In sub-Saharan Africa, women disproportionately represent the majority of new HIV infections. An estimated 44 percent of couples in Kenya are HIV-serodiscordant, in which one partner is infected by HIV and the other is not. But about 20 to 50 percent of HIV-infected people still want to have children, according to previous research.

Current guidelines recommend antiretroviral treatment in HIV-serodiscordant couples -- the therapy helps keep HIV at low levels, keeping people healthy for longer and reducing the risk of spreading HIV to others.

But the effectiveness of antiretroviral therapy may not be routinely assessed or guaranteed with an undetectable HIV viral load, authors say.

"We know there's a strong desire among many HIV-affected couples to have children but that current strategies to suppress the virus may be inadequate," says Mmeje, who is also a member of the U-M Institute for Healthcare Policy and Innovation.

"More options to support safely becoming pregnant should be offered to these couples and integrated into HIV prevention programs," she says.

Mmeje says health care providers caring for HIV-serodiscordant couples should also consider offering them a fertility evaluation before attempting to conceive or after several unsuccessful attempts.

Study participants were recruited from eight HIV care and treatment clinics in the Kisumu area of Western Kenya and included women ages 18 to 34. Instructional aids were used for the procedures, education and counseling sessions.

Couples were observed for two months before timed vaginal insemination and were tested and treated for sexually transmitted infections. Timed vaginal insemination was performed for up to six menstrual cycles, and a fertility evaluation was offered to couples who did not become pregnant.

Mmeje notes that the method and best practices described in the pilot study could be implemented by HIV prevention programs globally.

"Our findings are applicable to low-resource environments throughout the world," she says. "This strategy could have high impact on empowering HIV-affected women with an affordable and readily accessible reproductive option that supports their desire to have children."
-end-


Michigan Medicine - University of Michigan

Related Hiv Articles:

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.
The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.
Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.
NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
First ever living donor HIV-to-HIV kidney transplant
For the first time, a person living with HIV has donated a kidney to a transplant recipient also living with HIV.
The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.
Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.
HIV RNA expression inhibitors may restore immune function in HIV-infected individuals
Immune activation and inflammation persist in the majority of treated HIV-infected individuals and is associated with excess risk of mortality and morbidity.
HIV vaccine elicits antibodies in animals that neutralize dozens of HIV strains
An experimental vaccine regimen based on the structure of a vulnerable site on HIV elicited antibodies in mice, guinea pigs and monkeys that neutralize dozens of HIV strains from around the world.
State-of-the-art HIV drug could curb HIV transmission, improve survival in India
An HIV treatment regimen already widely used in North America and Europe would likely increase the life expectancy of people living with HIV in India by nearly three years and reduce the number of new HIV infections by 23 percent with minimal impact on the country's HIV/AIDS budget.
More Hiv News and Hiv Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.