XIX International AIDS Conference

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THPE293 - Poster Exhibition


Preventing HIV transmission from women and men living with HIV through reproductive and sexual health care: the framework of the 2012 Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) recommendations for HI

G. Dumitru, M. Sutton, S. Nesheim, K. Irwin

Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, United States

Background: Over 1.2 million people are living with HIV (PLWH) in the U.S. Ongoing transmission from PLWH drives HIV incidence; on average, each PLWH infects about five other persons over a lifetime. Most PLWH remain sexually active after their HIV diagnosis. The many PLWH who do not use condoms or other contraceptives are at risk of transmitting HIV to partners or offspring. Many PLWH desire to conceive using methods that reduce risk of sexual and perinatal transmission. In 2012, CDC and HRSA will issue new recommendations for clinicians, community-based organizations (CBO's), and health departments (HD) to promote HIV prevention with PLWH in the context of reproductive and sexual health care. The rationale, methodology, and evidence for these recommendations and CDC's and HRSA's plans to disseminate and offer training on these new recommendations are described.
Methods: Many recommendations were based on recent guidelines about reproductive and sexual health from CDC, HRSA, other U.S. governmental agencies, and the World Health Organization. The recommendations were also grounded in new scientific evidence, program evaluations, and opinions from organizations of PLWH, HIV providers, CBO's and HD's.
Results: These behavioral and biomedical interventions are described: safe sexual activity among heterosexual and homosexual serodiscordant and seroconcordant couples; family planning to prevent unintended pregnancy; preconception counseling to identify the safest timing and methods for conception; assisted conception methods that reduce sexual and perinatal transmission; antiretroviral use during pregnancy and the post-natal period; infant antiretroviral prophylaxis; prenatal and perinatal HIV testing; STI screening and treatment; Caesarean delivery; management of invasive prenatal and intrapartum procedures; and safe infant feeding options.
Conclusions: These new recommendations define essential actions clinicians, community organizations, and health departments can take to promote the prevention of sexual and perinatal HIV transmission with their patients, clients, and communities.


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