Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach

Dominika L Seidman, Shannon Weber, Deborah Cohan

HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women’s vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV. We then describe a clinical approach to caring for women who both choose and decline pre-exposure prophylaxis during pregnancy and postpartum, highlighting areas for future research.

March 10, 2017
Year of publication
2017
Tags
lactation, HIV testing, HIV counseling and testing (HCT), HIV testing and counseling (HTC), postpartum care, pre-exposure prophylaxis (PrEP), PrEP, serodiscordant couples, safe pregnancy, PMTCT, sexual and reproductive health (SRH), rights-based approach, pregnancy outcomes, HIV prevention, prevention of mother-to-child transmission (PMTCT), family planning, safe conception