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Citation Information

Type Journal Article - AIDS Care
Title Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya
Author(s)
Volume 27
Issue 1
Publication (Day/Month/Year) 2015
Page numbers 10-16
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221525/
Abstract
In female-positive HIV-serodiscordant couples desiring children, home timed vaginal insemination of semen during the fertile period along with consistent condom use may reduce the risk of HIV transmission when the man is HIV-uninfected. In sub-Saharan Africa, up to 45% of HIV-infected women desire to have more children. HIV viral load assessment is not routinely available in low-resource countries for monitoring adherence and response to antiretroviral therapy. Therefore, in these settings, timed unprotected intercourse without assurance of HIV viral suppression may pose unnecessary risks. Timed vaginal insemination, a simple and affordable intervention, can be considered an adjunct method and option of safer conception for HIV prevention with treatment of the HIV-infected partner and/or pre-exposure prophylaxis. We conducted five mixed and single sex focus group discussions comprised of 33 HIV-serodiscordant couples and healthcare providers in the Nyanza region of Kenya to assess the acceptability and feasibility of timed vaginal insemination as a safer method of conception. The transcribed data was analyzed using a grounded theory approach. We found that educating and counseling HIV-serodiscordant couples on timed vaginal insemination could make it an acceptable and feasible safer conception method when associated with frequent communication and home visits by healthcare providers. The findings of this study indicate that implementation studies that integrate training and counseling of HIV-serodiscordant couples and healthcare providers on timed vaginal insemination combined with consistent condom use are needed. Acknowledging and supporting the reproductive choice and needs of female positive, male negative HIV-serodiscordant couples who desire children should also include the use of assisted reproductive services at the same time as pharmaceutical options that prevent sexual HIV transmission.

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