Preexposure prophylaxis and timed intercourse for HIVdiscordant couples willing to conceive a child

1
Pre-exposure prophylaxis and timed intercourse
for HIV-discordant couples willing to conceive a
childP. Vernazza1 I. Brenner1 , I. Graf2
1Division of Infectious Diseases and 2Social
Services, Cantonal Hospital St. Gallen,
4th IAS Conference on HIV Pathogenesis, Treatment
and Prevention, 22 - 25 July 2007, Sydney,
Australia
2
HIV-discordant couples in Insemination Program
HIV-RNA in semen
Are we reducing a zero Risk ?
3
HIV, Pregnancy and Prevention

• Retrospective analysis Semprini
• 500 couples contacted after counselling
• Half of couples had conceived natrually
• 1 woman was HIV-infected
• ? Is our intervention missing its target?

4
License to LoveCounselling of HIV-d/c couples

• Information of both partner about transmission
  risks
• Rule out asymptomatic STDs
• Maintain fully suppressive HAART
• Timing of unprotected intercourse ? 36 h after
  LH-peak (urin)
• HIV-Pre-Exposure Prophylaxis (TDF)? 2 doses 0
  and 24 hafter LH-peak

5
License to LovePregnancy-rates in first 22
couples