Abstract
Today, under ideal conditions with combination antiretroviral therapy (cART), HIV
is a chronic illness with a normal life expectancy. As such, people with HIV are pursuing
experiences that once escaped them, such as parenthood. One of the most important
factors in reducing perinatal HIV transmission was, and still is, adequate planning.
And pregnancy planning has a few additional implications for people affected by HIV,
not unlike for people with other chronic illnesses. In 2018, the updated Canadian
HIV Pregnancy Planning Guidelines (CHPPGs) were published with 36 recommendations.
To help pregnancy care providers use the CHPPGs in pregnancy planning counselling
for people living with HIV and their partners, this paper summarizes 5 key considerations
in the modern era of HIV management.
Résumé
De nos jours, dans des conditions idéales et lorsqu'il fait l'objet d'un traitement
antirétroviral combiné, le VIH est une maladie chronique avec laquelle les personnes
atteintes peuvent avoir une espérance de vie normale. Par conséquent, ces personnes
aspirent à des expériences qui autrefois leur étaient refusées, notamment la parentalité.
Un des plus importants facteurs de réduction de la transmission périnatale du VIH
était et demeure la planification adéquate. La planification de la grossesse comporte
quelques implications supplémentaires pour les personnes atteintes du VIH; comme c'est
le cas pour celles qui souffrent d'autres maladies chroniques. La directive mise à
jour intitulée Lignes directrices canadiennes en matière de planification de la grossesse en présence
du VIH a été publiée en 2018 et comporte 36 recommandations. Afin d'aider les fournisseurs
de soins obstétricaux à intégrer ces lignes directrices dans leurs conseils de planification
de la grossesse pour les personnes atteintes du VIH et leur partenaire, cet article
résume 5 considérations principales de l’ère moderne de la prise en charge du VIH.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Obstetrics and Gynaecology CanadaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Recommendations for the use of antiretroviral drugs in pregnant women with HIV infection and interventions to reduce perinatal HIV transmission in the United States.U.S. Department of Health and Human Services, 2020: 383
- Achievements in public health: reduction in perinatal transmission of HIV infection — United States, 1985—2005.Department of Health and Human Services, Atlanta2006 (Available at:) (Accessed on April 10, 2020)
- UNAIDS statement on the forced and coerced sterilization of women living with HIV.UNAIDS, Geneva2020 (Available at:) (Accessed on November 8, 2020)
- No perinatal HIV-1 transmission from women with effective antiretroviral therapy starting before conception.Clin Infect Dis. 2015; 61: 1715-1725
- No. 354-Canadian HIV pregnancy planning guidelines.J Obstet Gynaecol Can. 2018; 40: 1-21
- Antiretroviral therapy for the prevention of HIV-1 transmission.N Engl J Med. 2016; 375: 830-839
- Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet. 2019; 393: 2428-2438
- Access to infertility services in Canada for HIV-positive individuals and couples: a cross-sectional study.Reprod Health. 2010; 7: 1-6
- Access to fertility services in Canada for HIV-positive individuals and couples: a comparison between 2007 and 2014.AIDS Care. 2017; 29: 1433-1436
- Decreased semen volume and spermatozoa motility in HIV-1-infected patients under antiretroviral treatment.J Androl. 2007; 28: 444-452
- The relationship between HIV and fertility in the era of antiretroviral therapy in sub-Saharan Africa: evidence from 49 demographic and health surveys.Trop Med Int Heal. 2017; 22: 1542-1550
- Drug interactions between hormonal contraceptives and antiretrovirals.AIDS. 2017; 31: 917-952
- HIV incidence among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: a randomised, multicentre, open-label trial.Lancet. 2019; 394: 303-313
Article info
Publication history
Published online: November 30, 2020
Footnotes
Disclosures: The authors declare they have nothing to disclose.
Each author has indicated they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
