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.
Preconception Counseling and Care for Women of Childbearing Age Living with HIV
Reproductive Options for Couples in Which One or Both Partners are Living with HIV
Last Updated: December 7, 2018; Last Reviewed: December 7, 2018
For Couples Who Want to Conceive When One or Both Partners are Living with HIV:
|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
|TDF2||1,219 sexually active adults; 55% male, 45% female; 94 % unmarried; approximately 90% aged 21–29 years
||Botswana||Daily oral TDF/FTC
||>30% did not complete study; cannot draw definitive conclusions for women and men separately.
|PIP||4,758 serodiscordant heterosexual couples; 38% HIV-negative female, 68% HIV-negative male partner; 98% married; median age 33 years
||Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda, Zambia
||Daily oral TDF or TDF/FTC
||67% protection with TDF alone; 75% protection with TDF/FTC
||Serodiscordant couples may be a distinct, unique population.
||1,951 heterosexual women aged 18–35 years at high risk of infection
||Kenya, South Africa, Tanzania
||Daily oral TDF/FTC
||Trial discontinued for futility in April 2011.
||Adherence assessment with monthly clinical samples to measure drug concentration is pending.
|5,029 heterosexual women aged 18–45 years in high prevalence areas of HIV
||Uganda, South Africa, Zimbabwe
||Daily oral TDF or daily oral TDF/FTC or daily topical TFV gel
||No study drug significantly reduced the risk of HIV acquisition. Estimates of effectiveness were <0 for TDF and TDF/FTC daily oral dosing (negative 48.8% and negative 4.2% TDF/FTC respectively), and reduced risk of HIV infection of 14.7% for TFV gel.
||Adherence to study drugs was low; TFV was detected in 30% of the oral TFV arm, 29% in the oral TDF/FTC arm, and 25% in the TFV gel arm.
|Adapted from: Kashuba et al., Pre-exposure prophylaxis for HIV prevention: how to predict success: Table Antiretroviral-based HIV prevention studies. Lancet. 2012;379(9835): 2409-2411.
Key to Acronyms: FTC = emtricitabine; TDF = tenofovir disoproxil fumarate; TFV = tenofovir
- AIDSinfo Drug Database
- AIDSinfo Patient Materials: Preventing Mother-to-Child Transmission of HIV
- AIDSinfo Patient Materials: HIV Medicines During Pregnancy and Childbirth
- AIDSinfo Patient Materials: Protecting Baby from HIV
- AETC National HIV Curriculum
- How to Cite These Guidelines
- Perinatal Guidelines Archive