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Achieving safe conception in HIV-discordant couples: the potential role of oral preexposure prophylaxis (PrEP) in the United States

Published:April 01, 2011DOI:https://doi.org/10.1016/j.ajog.2011.02.026
      Approximately half of HIV-discordant heterosexual couples in the United States want children. Oral antiretroviral preexposure prophylaxis, if effective in reducing heterosexual HIV transmission, might be an option for discordant couples wanting to conceive. Couples should receive services to ensure they enter pregnancy in optimal health and receive education about all conception methods that reduce the risk of HIV transmission. In considering whether preexposure prophylaxis is indicated, the question is whether it contributes to lowering risk in couples who have decided to conceive despite known risks. If preexposure prophylaxis is used, precautions similar to those in the current heterosexual preexposure prophylaxis trials would be recommended, and the unknown risks of preexposure prophylaxis used during conception and early fetal development should be considered. Anecdotal reports suggest that oral preexposure prophylaxis use is already occurring. It is time to have open discussions of when and how preexposure prophylaxis might be indicated for HIV-discordant couples attempting conception.

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      Linked Article

      • Safer conception options for HIV-serodiscordant couples
        American Journal of Obstetrics & GynecologyVol. 206Issue 1
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          In the short time since publication of the review of Lampe et al1 of preexposure prophylaxis (PrEP) and other safer conception options for human immunodeficiency virus (HIV)-serodiscordant couples, results from 2 important studies have been released. These studies are significant additions to the landscape of safer conception options.
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