title: Safer conception interventions for HIV-affected couples: implications for resource-constrained settings.
abstract: Developing and testing safer conception methods that reduce HIV transmission to HIV-seronegative partners in serodiscordant couples and reduce superinfection in HIV-seroconcordant couples is a crucial but often unaddressed component of HIV prevention programs. Most research has focused on developed-world settings, where "high-technology" assisted reproduction techniques are used for HIV-serodiscordant couples in which the male is HIV-infected. There is a dearth of research on safer conception methods for HIV-seropositive women and "low-technology" harm-reduction strategies for HIV-affected couples, including vaginal insemination for HIV-seropositive women and natural conception methods for HIV-seroconcordant and -serodiscordant couples. This review summarizes international studies of safer conception interventions for HIV-affected couples, with a focus on feasibility in public-sector health settings where assisted reproductive technology is not readily available. Given that such low-technology options are feasible in most settings, well-designed, prospective interventions offering low-technology safer conception methods need to be developed and tested.
authors.affiliation: Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Rachelle J
authors.initials: RJ
authors.lastname: Chadwick
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moodley
authors.forename: Jane
authors.initials: J
authors.lastname: Harries
authors.forename: Virginia
authors.initials: V
authors.lastname: Zweigenthal
authors.forename: Diane
authors.initials: D
authors.lastname: Cooper
mesh_terms: D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D005306:Fertilization; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D040261:Harm Reduction; D006801:Humans; D012747:Sexual Partners