Endorsements supporting safer conception and pregnancy for men and women living with and affected by HIV
In May 2017, AIDS and Behavior published a consensus statement on the provision of safer conception services for men and women living with and affected by HIV.

The consensus statement was developed by a coalition of advocates, clinicians, researchers and community members.

Co-authors: Lynn T. Matthews (USA), Jolly Beyeza-Kashesya (Uganda), Ian Cooke (UK), Natasha Davies (South Africa), Renee Heffron (USA), Angela Kaida (Canada), John Kinuthia (Kenya), Okeoma Mmeje (USA), Augusto E. Semprini (Italy), and Shannon Weber (USA)

First Endorsements: Suan Cu-Uvin, Lynne M. Mofenson, Sheila Eshiwani, Elaine Abrams, Deborah Cohan, Southern African HIV Clinicians Society, Nelly Mugo, Chelsea Polis, Mark Yudin, Jared Baeten, Rhoda K. Wanyenze, Sheree Schwartz, Deborah Money, Glenn Wagner, Mona Loutfy, David Bangsberg, Brittney Alexander, Alison Roxby, Ruanne Barnabas, Keshet Ronen, McKenna Eastment, Anne Kaggiah, Kenneth Ngure, Sylvia LaCourse, Jennifer Balkus, Kerry A. Thomson, Jennifer A. Unger, Daisy Krakowiak, Elizabeth Irungu, Professor Adam Balen, Njambi Njuguna, Sarah Gimbel, Judith N. Wasserheit, Lawrence Mwaniki, Peterson Mwaniki Ngunga, Lynda Oluoch, Precious Audia Robinson, Francois Venter, Craig R. Cohen, Cameron McConkey, Edwin Bernard, David English, Yamini Oseguera-Bhatnagar, Jill Davies, Grace John-Stewart, Kate Salters, Reuben Granich, Jacque Wambui, Alison Drake, Diane Cooper, Sarah Finocchario Kessler, Andrea Ciaranello, Sarah Massoud, Nathan Lachowsky, Nadia O'Brien, Hazar Khidir, Rena Patel, Ellen Eyi Klutsey


Abstract

Safer conception interventions reduce HIV incidence while supporting the reproductive goals of people living with or affected by HIV. We developed a consensus statement to address demand, summarize science, identify information gaps, outline research and policy priorities, and advocate for safer conception services.

This statement emerged from a process incorporating consultation from meetings, literature, and key stakeholders. Three co-authors developed an outline which was discussed and modified with co-authors, working group members, and additional clinical, policy, and community experts in safer conception, HIV, and fertility. Co-authors and working group members developed and approved the final manuscript.

Consensus across themes of demand, safer conception strategies, and implementation were identified. There is demand for safer conception services. Access is limited by stigma towards PLWH having children and limits to provider knowledge. Efficacy, effectiveness, safety, and acceptability data support a range of safer conception strategies including ART, PrEP, limiting condomless sex to peak fertility, home insemination, male circumcision, STI treatment, couples-based HIV testing, semen processing, and fertility care. Lack of guidelines and training limit implementation. Key outstanding questions within each theme are identified.

Consumer demand, scientific data, and global goals to reduce HIV incidence support safer conception service implementation. We recommend that providers offer services to HIV-affected men and women, and program administrators integrate safer conception care into HIV and reproductive health programs. Answers to outstanding questions will refine services but should not hinder steps to empower people to adopt safer conception strategies to meet reproductive goals.

Read the full manuscript here: http://link.springer.com/article/10.1007/s10461-017-1777-7

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