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PrEP as Peri-conception HIV Prevention for Women and Men

  • The Science of Prevention (JD Stekler and J Baeten, Section Editors)
  • Published:
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Abstract

Daily oral tenofovir (TDF)-based pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy and recommended for men and women with substantial risk of HIV acquisition. The peri-conception period, the stage prior to pregnancy when condom use is necessarily reduced, has elevated HIV risk that can be mitigated by PrEP use. Data from a randomized trial suggest that peri-conception PrEP use by HIV-seronegative women does not increase the risk of pregnancy loss, birth defects or congenital anomalies, preterm birth, or infant growth faltering. Women considering PrEP use throughout pregnancy must weigh the known increased risk of HIV acquisition with unknown risks of drug effects on infant growth. PrEP has been used safely by HIV-seronegative men with HIV-seropositive female partners who have become pregnant. As an effective user-controlled HIV prevention strategy, PrEP offers autonomy and empowerment for HIV prevention and can be recommended alongside antiretroviral therapy, fertility screening, vaginal self-insemination, intercourse timed to peak fertility, medically assisted reproduction, and other safer conception strategies to provide multiple options. The integration of PrEP into safer conception programs is warranted and will safely reduce HIV transmission to women, men, and children during the peri-conception period.

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Authors and Affiliations

  1. Departments of Global Health and Epidemiology, University of Washington, 325 Ninth Avenue, Box 359927, Seattle, WA, 98104, USA

    Renee Heffron

  2. School of Nursing, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA, 98104, USA

    Jillian Pintye

  3. Division of Infectious Disease and Center for Global Health, Massachusetts General Hospital, 125 Nashua Street, Suite 722, Boston, MA, 02114, USA

    Lynn T. Matthews

  4. University of California San Francisco, 1001 Potrero Ave, 6D-33, San Francisco, CA, 94110, USA

    Shannon Weber

  5. Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya

    Nelly Mugo

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  1. Renee Heffron
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  2. Jillian Pintye
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  5. Nelly Mugo
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Correspondence to Renee Heffron.

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Conflict of Interest

Renee Heffron is the Principal Investigator for a study that has received donated FTC/TDF from Gilead Sciences LLC. Jillian Pintye, Lynn T. Matthews, Shannon Weber, and Nelly Mugo declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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RH was supported by R00 HD 076679 and LTM was supported by K23 MH095655.

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Heffron, R., Pintye, J., Matthews, L.T. et al. PrEP as Peri-conception HIV Prevention for Women and Men. Curr HIV/AIDS Rep 13, 131–139 (2016). https://doi.org/10.1007/s11904-016-0312-1

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