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. 2021 Oct 25;2021(4):hoab037. doi: 10.1093/hropen/hoab037
Human immunodeficiency virus (HIV)-1-serodiscordant couples should be informed that there is a risk of sexual transmission of the virus to the unaffected partner. To reduce this risk, couples must be advised to use barrier contraception and seek active therapy to reduce viral load (Baggaley et al., 2010; LeMessurier et al., 2018). Strong
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Individuals testing positive for HIV-1, antiretroviral therapy can suppress viral replication. These patients should remain on antiretroviral therapy and providing undetectable viral loads in serum can be achieved and sustained, the risk of horizontal transmission through unprotected intercourse is minimal in the absence of other sexually transmitted diseases (Attia et al., 2009). Strong
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Commencing with medically assisted reproduction (MAR) treatments in patients positive for HIV-1 or 2 should be a joint decision between the patient, their partner, the fertility doctor and the infectious disease specialist. Strong
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All patients testing positive for HIV, wishing to have a child should be counseled about the risk of horizontal and vertical transmission. In the case of the male testing positive for HIV, antiretroviral therapy can reduce the viral load in blood and semen to undetectable levels, allowing the possibility of natural conception. Reproductive counseling should include fertility and antiretroviral covariates. GPP
In the case of the female testing positive for HIV-1 or 2, and even with undetectable viremia, the possibility of viral vertical transmission should be discussed prior to MAR treatment. GPP