SAFER: Safer conception strategies to prevent HIV transmission among HIV sero-different couples desiring pregnancy

Safer conception strategies are needed to minimize HIV transmission among
HIV sero-different couples desiring pregnancy. Few studies have evaluated
the choices couples make when offered multiple safer conception methods,
or method acceptability. We piloted a comprehensive safer conception
program for HIV-sero-different couples planning pregnancy in Zimbabwe,
measuring feasibility, method uptake, acceptability, pregnancy, and HIV
transmission. Couples in this prospective study were given a
choice of one or more safer conception methods: antiretroviral therapy
(ART) with monthly viral load (VL) monitoring for the HIV-positive partner
(ART/VL), pre-exposure prophylaxis (PrEP) for the HIV-negative partner,
vaginal insemination (VI) for couples with an HIV-positive woman, and
semen washing (SW) for couples with an HIV-positive man. Couples were
followed monthly for up to 12 months of pregnancy attempts, quarterly
during pregnancy, and 12 weeks post-partum.  At each
visit, data on method use, urine for pregnancy testing, and blood for HIV
antibody testing, or viral load if HIV-positive, were obtained. Infants
born to HIV-positive women were tested for HIV at 6 and 12
weeks.