Periconception HIV Risk Behavior Among Men and Women Reporting HIV-Serodiscordant Partners in KwaZulu-Natal, South Africa

• Published in: AIDS and behavior Vol. 19; no. 12; pp. 2291 - 2303
• Main Authors: Matthews, L. T., Smit, J. A., Moore, L., Milford, C., Greener, R., Mosery, F. N., Ribaudo, H., Bennett, K., Crankshaw, T. L., Kaida, A., Psaros, C., Safren, S. A., Bangsberg, D. R.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2015; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral agents; Antiretroviral therapy; Artificial insemination; Circumcision; Condoms; Couples; Data collection; Drugs; Family planning; Female; Fertility; Health Psychology; Health risks; HIV; HIV Infections - epidemiology; HIV Infections - transmission; HIV Seropositivity; Human immunodeficiency virus; Humans; Infectious Diseases; Knowledge; Male; Medicine; Medicine & Public Health; Men; Original Paper; Pregnancy; Public Health; Risk; Risk taking; Safe Sex; Self disclosure; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; South Africa; STD; Young Adult; South Africa; Serodiscordant couples; South Africa; PMTCT; Safer conception
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-015-1050-x

HIV-infected men and women who choose to conceive risk infecting their partners. To inform safer conception programs we surveyed HIV risk behavior prior to recent pregnancy amongst South African, HIV-infected women (N = 209) and men (N = 82) recruited from antenatal and antiretroviral clinics, respectively, and reporting an uninfected or unknown-HIV-serostatus pregnancy partner. All participants knew their HIV-positive serostatus prior to the referent pregnancy. Only 11 % of women and 5 % of men had planned the pregnancy; 40 % of women and 27 % of men reported serostatus disclosure to their partner before conception. Knowledge of safer conception strategies was low. Around two-thirds reported consistent condom use, 41 % of women and 88 % of men reported antiretroviral therapy, and a third of women reported male partner circumcision prior to the referent pregnancy. Seven women (3 %) and two men (2 %) reported limiting sex without condoms to peak fertility. None reported sperm washing or manual insemination. Safer conception behaviors including HIV-serostatus disclosure, condom use, and ART at the time of conception were not associated with desired pregnancy. In light of low pregnancy planning and HIV-serostatus disclosure, interventions to improve understandings of serodiscordance and motivate mutual HIV-serostatus disclosure and pregnancy planning are necessary first steps before couples or individuals can implement specific safer conception strategies.