TABLE 3.

Prepregnancy screening for HIV-positive individuals desiring a child in resource-limited and resource-intensive settings.

Female partner

Male partner

Viral load on ART CD4+ count Syphilis and hepatitis B serology Syndromic screening for other STIs or †hepatitis A, B and C serology, syphilis, gonorrhoea, chlamydia, trichomonas, HSV-2 screening Haemoglobin or †full blood count Visual inspection of the cervix and pap smear/VIA in absence of documented normal result in the previous 12 months and/or †HPV screening Non-communicable diseases screen (hypertension, diabetes, weight review, †cholesterol) †CMV, rubella, toxoplasmosis †If infertility suspected or no pregnancy after six months, refer for fertility assessment

Viral load on ART CD4+ count Syphilis and hepatitis B serology Syndromic screening for other STIs or †hepatitis A, B and C, syphilis, gonorrhoea, chlamydia, trichomonas, HSV-2 screening Non-communicable diseases screen (hypertension, diabetes, weight review, †cholesterol) †If difficulty conceiving: refer for semen analysis and fertility assessment

VIA, visual inspection with acetic acid; CMV, cytomegalovirus; HSV, herpes simplex virus; ART, antiretroviral therapy; STIs, sexually transmitted infections; HPV, human papilloma virus.

Note: CD4+ count is not required for ART eligibility but rather to assess HIV advancement and immunological well-being.

^†, Screening that is typically only available in resource-intensive settings.