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Are You an HIV-Positive Woman Trying to Conceive?

A new study supports timed vaginal insemination as a safe, feasible method by which HIV-positive women can conceive HIV-free babies.

June 21, 2019

If you or your partner has tested HIV-positive, you may be familiar with the challenges it poses to traditional conception. However, thanks to modern science, we no longer live in a world where there is only one way to have a baby.

Diving into the seemingly limitless depths of scientific research on conception is a daunting, not to mention overwhelming, task, to say the least. With new findings being published constantly, it can be difficult to keep track of what’s happening with the latest medical technology, especially one as full of momentum as discovering new conception strategiesj

Recently, researchers found that timed vaginal insemination is a viable method to conceive for HIV positive women. Read more for a breakdown of the findings, including:

  • What timed vaginal insemination is, and how it works
  • An overview of the study and its results
  • Pros and cons to this method of conception

What is timed vaginal insemination, and how does it work?

Timed vaginal insemination (TVI) requires women to inseminate artificially with a syringe at several points throughout the woman’s ovulation period (as follows):

  • Two days prior to ovulation,
  • On the estimated day of ovulation,
  • And two days after ovulation.

Heterosexual couples may try this method by collecting semen after sexual intercourse with a water-based, lubricated condom.


Positive rapid pregnancy test stick.
Image from FirstCry Parenting.

What did the study on TVI entail, and what were the results?

The study

Due to the presence of HIV in sub-Saharan Africa, participants for the study were recruited from Western Kenya. According to the published report, “Eligible study participants were heterosexual HIV-serodiscordant [only one partner has HIV] couples who self-reported the following: 1.) monogamous relationship and disclosure of HIV status to the male sexual partner; 2.) childbearing desires’ 3.) sexually active (at least 3 encounters per month); and 4.) the women were aged 18-34 years.”

Two African women walk down the road carrying baskets on their heads.
In sub-Saharan Africa, women are disproportionately HIV-positive and consequently, around 44 percent of couples are HIV-serodiscordant, meaning one partner has HIV but the other does not.


The approved couples were taught the semen-collecting procedure, in which used syringes were stained with methylene blue in order to identify vaginal epithelial cells. The presence of vaginal epithelial cells was used as an internal validation of TVI compliance.

The results

For 23 couples, timed vaginal insemination allowed for 6 live births with no HIV transmission.

Flow chart showing results of study.
Flow chart depicting the results. Image from PMC.

Pros and cons to TVI, as indicated by the study

Pros

The study suggests TVI is a both safe and feasible method by which HIV-positive women can conceive HIV-free babies.

Additionally, TVI does not appear to risk HIV transmission to the male partner, due to the use of a condom.  

Lead researcher Okeoma Mmeje, M.D., of Michigan Medicine says of the study, "Our findings are applicable to low-resource environments throughout the world . . . This strategy could have high impact on empowering HIV-affected women with an affordable and readily accessible reproductive option that supports their desire to have children."

Cons

Unfortunately, this method of conception would only work for heterosexual couples.

Furthermore, the results derived from the study are only valid in couples in which the female partner is HIV-positive, not the male.

TVI also seems as though it might be more susceptible to the risk of human error, as the couple is largely responsible for carrying out the procedure effectively.

Conclusions: Timed vaginal insemination shows promise as an effective way for HIV-positive women to successfully conceive an HIV-negative baby.

This study is especially groundbreaking for women in countries with similar socio-economic challenges as those in sub-Saharan Africa.

"We know there's a strong desire among many HIV-affected couples to have children but that current strategies to suppress the virus may be inadequate," continues Mmeje.

"More options to support safely becoming pregnant should be offered to these couples and integrated into HIV prevention programs.”

...

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