Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Preconception Counseling and Care for Women of Childbearing Age Living with HIV

Overview

Last Updated: December 24, 2019; Last Reviewed: December 24, 2019

Panel's Recommendations Regarding Preconception Counseling and Care for Women of Childbearing Age Living with HIV
Panel's Recommendations
  • Discuss reproductive desires with all women of childbearing age on an ongoing basis throughout the course of their care (AIII).
  • Provide information about effective and appropriate contraceptive methods to reduce the likelihood of unplanned pregnancy (AI).
  • During preconception counseling, provide information on safe sex and encourage the elimination of alcohol, tobacco, and other drugs of abuse; if elimination is not feasible, clinicians should provide appropriate treatment (e.g., methadone or buprenorphine) or counsel patients on how to manage health risks (e.g., use of a syringe services program) (AII).
  • Women with HIV should attain maximum viral suppression before attempting conception for their own health, to prevent sexual HIV transmission to partners without HIV (AI), and to minimize the risk of perinatal HIV transmission to the infant (AI).
  • When selecting or evaluating an antiretroviral (ARV) regimen for women of childbearing age with HIV, consider a regimen’s effectiveness, a woman’s hepatitis B status, the teratogenic potential of the drugs in the ARV regimen, and the possible adverse outcomes for the mother and fetus (AII). See Teratogenicity and Recommendations for Use of Antiretroviral Drugs During Pregnancy for more information. The Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission emphasizes the importance of counseling and informed decision-making regarding all ARV regimens for people with HIV (AIII).
  • HIV infection does not preclude the use of any contraceptive method; however, drug-drug interactions between hormonal contraceptives and antiretrovirals should be considered (AII).
Rating of Recommendations: A = Strong; B = Moderate; C = Optional

Rating of Evidence: I = One or more randomized trials with clinical outcomes and/or validated laboratory endpoints; II = One or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion

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