Risk Reduction for HIV Serodiscordant Couples Attempting Conception

The goal of this study is to develop a preliminary understanding of the social and cultural context in which HIV serodiscordant couples in Kenya are making the decision to become pregnant. The specific aims of this study are:

• To explore the motivations for conception, understanding the risk of HIV transmission, and the decisionmaking process of serodiscordant couples desiring pregnancy.
• To assess the acceptability of:
• Limiting unprotected intercourse to the fertile window in a woman’s cycle to reduce the number of episodes of unprotected sex per month.
• Providing the HIV- partner with antiretroviral medication to take prior to unprotected intercourse to reduce the risk of HIV transmission.
• Starting antiretroviral medication in the HIV+ partner, regardless of immune status and clinical staging to reduce genital tract viral shedding and possibly HIV transmission.
• Sperm washing to isolate spermatozoa from semen of HIV+ men, followed by intrauterine insemination using the prepared sperm in order to achieve pregnancy while preventing HIV transmission.

The study tool will consist of a structured questionnaire, followed by an in-depth interview. Fifteen discordant couples of reproductive age who express a general desire to have children in the future will be recruited from an existing AIDS care program in Kisumu, Kenya. Findings from this study will be used to design an investigation to determine the uptake and acceptability of these potential HIV prevention strategies.