title: Antiretrovirals and safer conception for HIV-serodiscordant couples.
abstract: OBJECTIVE
  Many men and women living with HIV and their uninfected partners attempt to conceive children. HIV-prevention science can be applied to reduce sexual transmission risk while respecting couples' reproductive goals. Here we discuss antiretrovirals as prevention in the context of safer conception for HIV-serodiscordant couples.
  
  
  RESULTS
  Antiretroviral therapy (ART) for the infected partner and pre-exposure prophylaxis (PrEP) for the uninfected partner reduce the risk of heterosexual HIV transmission. Several demonstration projects suggest the feasibility and acceptability of antiretroviral (ARV)s as periconception HIV-prevention for HIV-serodiscordant couples. The application of ARVs to periconception risk reduction may be limited by adherence.
  
  
  CONCLUSIONS
  For male-infected (M+F-) couples who cannot access sperm processing and female-infected (F+M-) couples unwilling to carry out insemination without intercourse, ART for the infected partner, PrEP for the uninfected partner, combined with treatment for sexually transmitted infections, sex limited to peak fertility, and medical male circumcision (for F+M couples) provide excellent, well tolerated options for reducing the risk of periconception HIV sexual transmission.
authors.affiliation: Massachusetts General Hospital, Center for Global Health and Division of Infectious Disease, Boston, USA. ltmatthe@bidmc.harvard.edu
authors.forename: Lynn T
authors.initials: LT
authors.lastname: Matthews
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Smit
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: Deborah
authors.initials: D
authors.lastname: Cohan
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D005306:Fertilization; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D012747:Sexual Partners
chemical_list: D019380:Anti-HIV Agents