title: Canadian HIV Pregnancy Planning Guidelines: No. 278, June 2012.
abstract: OBJECTIVE
  Four main clinical issues need to be considered for HIV-positive individuals and couples with respect to pregnancy planning and counselling: (1) pre-conceptional health; (2) transmission from mother to infant, which has been significantly reduced by combined antiretroviral therapy; (3) transmission between partners during conception, which requires different prevention and treatment strategies depending on the status and needs of those involved; and (4) management of infertility issues. The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist HIV-positive individuals and couples with their fertility and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible, and they take into account diverse and intersecting local/population needs and the social determinants of health.
  
  
  RESULTS
  Intended outcomes are (1) reduction of risk of vertical transmission and horizontal transmission of HIV, (2) improvement of maternal and infant health outcomes in the presence of HIV, (3) reduction of the stigma associated with pregnancy and HIV, and (4) increased access to pregnancy planning and fertility services.
  
  
  METHODS
  PubMed and Medline were searched for articles published in English or French to December 20, 2010, using the following terms: "HIV" and "pregnancy" or "pregnancy planning" or "fertility" or "reproduction" or "infertility" or "parenthood" or "insemination" or "artificial insemination" or "sperm washing" or "IVF" or "ICSI" or "IUI." Other search terms included "HIV" and 'horizontal transmission" or "sexual transmission" or "serodiscordant." The following conference databases were also searched: Conference on Retroviruses and Opportunistic Infections, International AIDS Conference, International AIDS Society, Interscience Conference on Antimicrobial Agents and Chemotherapy, the Canadian Association of HIV/AIDS Research, and the Ontario HIV Treatment Network Research Conference. Finally, a hand search of key journals and conferences was performed, and references of retrieved articles were reviewed for additional citations. Subsequently, abstracts were categorized according to their primary topic (based on an outline of the guidelines) into table format with the following headings: author, title, study purpose, participants, results and general comments. Finally, experts in the field were consulted for their opinions as to whether any articles were missed.
  
  
  METHODS
  The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table) and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines.
  
  
  BACKGROUND
  The Society of Obstetricians and Gynecologists of Canada, Women and HIV Research Program, Women's College Research Institute, Women's College Hospital, University of Toronto, Abbott Laboratories Canada, the Ontario HIV Treatment Network, the Canadian Institutes of Health Research, and the Canadian HIV Trials Network.
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
authors.forename: Shari
authors.initials: S
authors.lastname: Margolese
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.forename: Mathias
authors.initials: M
authors.lastname: Gysler
authors.forename: Scot
authors.initials: S
authors.lastname: Hamilton
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yudin
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D002170:Canada; D005193:Family Planning Services / Q000941:ethics / Q000331:legislation & jurisprudence; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology / Q000635:transmission*; D006297:Health Services Accessibility / Q000941:ethics / Q000331:legislation & jurisprudence; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000941:ethics / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D007246:Infertility / Q000523:psychology / Q000628:therapy; D011247:Pregnancy
chemical_list: D019380:Anti-HIV Agents