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 7, 2018; Last Reviewed: December 7, 2018

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 syringe services program) (AII).
  • All women living with HIV who are contemplating pregnancy should be receiving antiretroviral therapy (ART) and have a plasma viral load below the limit of detection prior to conception (AII).
  • When selecting or evaluating ART for women of childbearing age living with HIV, consider a regimen’s effectiveness, a woman’s hepatitis B status, teratogenic potential of the drugs in the ART regimen, and possible adverse outcomes for the mother and fetus (AII).
  • HIV infection does not preclude the use of any contraceptive method; however, drug-drug interactions between hormonal contraceptives and ART 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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