Unprotected sex versus assisted reproduction for conception in HIV-serodiscordant couples.
Article Type: Brief article
Subject: HIV infection (Risk factors)
HIV infection (Prevention)
Human reproductive technology (Usage)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Accession Number: 236247773
Full Text: Assisted reproduction techniques have developed substantially, allowing security for HIV-serodiscordant couples to conceive while protecting the HIV-negative partner and future child. This review analyses the available data and the arguments for and against assisted conception versus unprotected sexual intercourse targeting fertile days, which has been recently proposed for couples meeting specific criteria. Although the rate of HIV transmission from unprotected sex in serodiscordant couples in precise conditions--such as an undetectable viral load with antiretroviral treatment and sexual intercourse limited to fertile days--is very low, not zero, this paper stresses the various factors which can increase the risk of seroconversion in this population. Factors include the presence of vaginal infections or genital lesions, the presence of the virus in the genital reservoir, imperfect compliance with long-term antiretroviral therapy, the probable increased number of acts of sexual intercourse needed to conceive in asymptomatic HIV patients compared to the average population, and the concern that temporary consent for unprotected sex could weaken prevention policies and encourage couples to continue to practise unprotected sex. The authors therefore advise assisted reproduction techniques and safe sex, until evidence can demonstrate that unprotected sexual intercourse, targeted to fertile days, has no unexpected harmful consequences. (1)

(1.) Vandermaelen A, Englert Y. Human immunodeficiency virus serodiscordant couples on highly active antiretroviral therapies with undetectable viral load: conception by unprotected sexual intercourse or by assisted reproduction techniques? Human Reproduction 2010;25(2):374-79.
Gale Copyright: Copyright 2010 Gale, Cengage Learning. All rights reserved.