A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa

A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected... We conducted a systematic review of safer conception strategies (SCS) for HIV-affected couples in sub-Saharan Africa to inform evidence-based safer conception interventions. Following PRISMA guidelines, we searched fifteen electronic databases using the following inclusion criteria: SCS research in HIV-affected couples; published after 2007; in sub-Saharan Africa; primary research; peer-reviewed; and addressed a primary topic of interest (SCS availability, feasibility, and acceptability, and/or education and promotion). Researchers independently reviewed each study for eligibility using a standardized tool. We categorize studies by their topic area. We identified 41 studies (26 qualitative and 15 quantitative) that met inclusion criteria. Reviewed SCSs included: antiretroviral therapy (ART), pre-exposure prophylaxis, timed unprotected intercourse, manual/self-insemination, sperm washing, and voluntary male medical circumcision (VMMC). SCS were largely unavailable outside of research settings, except for general availability (i.e., not specifically for safer conception) of ART and VMMC. SCS acceptability was impacted by low client and provider knowledge about safer conception services, stigma around HIV-affected couples wanting children, and difficulty with HIV disclosure in HIV-affected couples. Couples expressed desire to learn more about SCS; however, provider training, patient education, SCS promotions, and integration of reproductive health and HIV services remain limited. Studies of provider training and couple-based education showed improvements in communication around fertility intentions and SCS knowledge. SCS are not yet widely available to HIV-affected African couples. Successful implementation of SCS requires that providers receive training on effective SCS and provide couple-based safer conception counseling to improve disclosure and communication around fertility intentions and reproductive health. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png AIDS and Behavior Springer Journals

A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Public Health; Health Psychology; Infectious Diseases
ISSN
1090-7165
eISSN
1573-3254
D.O.I.
10.1007/s10461-018-2170-x
Publisher site
See Article on Publisher Site

Abstract

We conducted a systematic review of safer conception strategies (SCS) for HIV-affected couples in sub-Saharan Africa to inform evidence-based safer conception interventions. Following PRISMA guidelines, we searched fifteen electronic databases using the following inclusion criteria: SCS research in HIV-affected couples; published after 2007; in sub-Saharan Africa; primary research; peer-reviewed; and addressed a primary topic of interest (SCS availability, feasibility, and acceptability, and/or education and promotion). Researchers independently reviewed each study for eligibility using a standardized tool. We categorize studies by their topic area. We identified 41 studies (26 qualitative and 15 quantitative) that met inclusion criteria. Reviewed SCSs included: antiretroviral therapy (ART), pre-exposure prophylaxis, timed unprotected intercourse, manual/self-insemination, sperm washing, and voluntary male medical circumcision (VMMC). SCS were largely unavailable outside of research settings, except for general availability (i.e., not specifically for safer conception) of ART and VMMC. SCS acceptability was impacted by low client and provider knowledge about safer conception services, stigma around HIV-affected couples wanting children, and difficulty with HIV disclosure in HIV-affected couples. Couples expressed desire to learn more about SCS; however, provider training, patient education, SCS promotions, and integration of reproductive health and HIV services remain limited. Studies of provider training and couple-based education showed improvements in communication around fertility intentions and SCS knowledge. SCS are not yet widely available to HIV-affected African couples. Successful implementation of SCS requires that providers receive training on effective SCS and provide couple-based safer conception counseling to improve disclosure and communication around fertility intentions and reproductive health.

Journal

AIDS and Behavior – Springer Journals

Published: Jun 4, 2018

References

  • High incidence of unplanned pregnancy after antiretroviral therapy initiation: findings from a prospective cohort study in South Africa
    Schwartz, SR; Rees, H; Mehta, S; Venter, WD; Taha, TE; Black, V
  • Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study
    Myer, L; Carter, RJ; Katyal, M
  • Fertility intentions of HIV-1 infected and uninfected women in Malawi: a longitudinal study
    Taulo, F; Berry, M; Tsui, A
  • The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda
    Beyeza-Kashesya, J; Kaharuza, F; Mirembe, F; Neema, S; Ekstrom, AM; Kulane, A
  • Increased risk of HIV-1 transmission in pregnancy: a prospective study among african HIV-1 serodiscordant couples
    Mugo, NR; Heffron, R; Donnell, D
  • Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive
    Vitorino, RL; Grinsztejn, BG; Andrade, CAF
  • The efficiency of sperm washing in removing human immunodeficiency virus type 1 varies according to the seminal viral load
    Fiore, JR; Lorusso, F; Vacca, M
  • Safety and efficacy of sperm washing in HIV-1-serodiscordant couples where the male is infected: results from the European CREAThE network
    Bujan, L; Hollander, L; Coudert, M
  • Reproductive assistance in HIV serodiscordant couples
    Savasi, V; Mandia, L; Laoreti, A
  • Implementation of a safer conception service for HIV-affected couples in South Africa
    Schwartz, SR; Bassett, J; Sanne, I
  • Acceptability and preferences for safer conception HIV prevention strategies: a qualitative study
    Schwartz, SR; West, N; Phofa, R
  • Periconception pre-exposure prophylaxis to prevent HIV transmission: benefits, risks, and challenges to implementation
    Matthews, LT; Baeten, JM; Celum, C
  • Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial
    Bailey, RC; Moses, S; Parker, CB
  • Promoting reproductive options for HIV-affected couples in sub-Saharan Africa
    Mmeje, O; Cohen, C; Murage, A
  • Distinct HIV discordancy patterns by epidemic size in stable sexual partnerships in sub-Saharan Africa
    Chemaitelly, H; Cremin, I; Shelton, J
  • Pregnancy and HIV transmission among HIV-discordant couples in a clinical trial in Kisumu
    Brubaker, SG; Bukusi, EA; Odoyo, J; Achando, J; Okumu, A; Cohen, CR
  • The prisma statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration
    Liberati, A; Altman, DG; Tetzlaff, J
  • Client uptake of safer conception strategies: implementation outcomes from the Sakh’umndeni safer conception clinic in South Africa
    Schwartz, SR; Bassett, J; Holmes, CB
  • Low receipt and uptake of safer conception messages in routine HIV care: findings from a prospective cohort of women living with HIV in South Africa
    Steiner, RJ; Black, V; Rees, H
  • My intention was a child but I was very afraid: fertility intentions and HIV risk perceptions among HIV-serodiscordant couples experiencing pregnancy in Kenya
    Ngure, K; Baeten, JM; Mugo, N
  • Reproductive desires of men and women living with HIV: implications for family planning counselling
    Zyl, C; Visser, MJ
  • Provider attitudes about childbearing and knowledge of safer conception at two HIV clinics in Malawi
    Kawale, P; Mindry, D; Phoya, A
  • Multi-level correlates of safer conception methods awareness and attitudes among Ugandan HIV clients with fertility intentions
    Wagner, GJ; Woldetsadik, MA; Beyeza-Kashesya, J
  • Reassuring birth outcomes with tenofovir/emtricitabine/efavirenz used for prevention of mother-to-child transmission of HIV in Botswana
    Zash, R; Souda, S; Chen, JY
  • Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya
    Mmeje, O; Poel, S; Workneh, M
  • Pre-exposure prophylaxis does not affect the fertility of HIV-1-uninfected men
    Were, EO; Heffron, R; Mugo, NR
  • Planning for HIV preexposure prophylaxis introduction: lessons learned from contraception
    Delany-Moretlwe, S; Mullick, S; Eakle, R
  • High medication adherence during periconception periods among HIV-1–uninfected women participating in a clinical trial of antiretroviral pre-exposure prophylaxis
    Matthews, LT; Heffron, R; Mugo, NR
  • ‘He lacks his fatherhood’: safer conception technologies and the biological imperative for fatherhood among recently-diagnosed Xhosa-speaking men living with HIV in South Africa
    Taylor, TN; Mantell, JE; Nywagi, N
  • Heffron R; Partners Demonstration Project Team. Safer conception among HIV-1 serodiscordant couples in East Africa: understanding knowledge, attitudes, and experiences
    Hancuch, K; Baeten, J; Ngure, K; Celum, C; Mugo, N; Tindimwebwa, E
  • Prevalence and correlates of use of safer conception methods in a prospective cohort of Ugandan HIV-affected couples with fertility intentions
    Wagner, GJ; Linnemayr, S; Goggin, K; Mindry, D; Beyeza-Kashesya, J; Finocchario-Kessler, S; Robinson, E; Birungi, J; Wanyenze, RK
  • Fertility preferences, condom use, and concerns among HIV-infected women in serodiscordant relationships in the era of antiretroviral therapy
    Ezeanochie, M; Olagbuji, B; Ande, A
  • Attitudes, knowledge, and correlates of self-efficacy for the provision of safer conception counseling among ugandan HIV providers
    Goggin, K; Finocchario-Kessler, S; Staggs, V
  • Periconception HIV risk behavior among men and women reporting HIV-serodiscordant partners in KwaZulu-Natal, South Africa
    Matthews, LT; Smit, JA; Moore, L
  • Semen decontamination for the elimination of seminal HIV-1
    Fourie, JM; Loskutoff, N; Huyser, C
  • Evaluating safer conception options for HIV-serodiscordant couples (HIV-infected female/HIV-uninfected male): a closer look at vaginal insemination
    Mmeje, O; Cohen, CR; Cohan, D
  • Factors associated with desire for children among HIV-infected women and men: a quantitative and qualitative analysis from Malawi and implications for the delivery of safer conception counseling
    Kawale, P; Mindry, D; Stramotas, S
  • Reproductive counseling by clinic healthcare workers in Durban, South Africa: perspectives from HIV-infected men and women reporting serodiscordant partners
    Matthews, LT; Crankshaw, T; Giddy, J
  • “If I don’t use a condom… I would be stressed in my heart that I’ve done something wrong”: routine prevention messages preclude safer conception counseling for HIV-infected men and women in South Africa
    Matthews, LT; Moore, L; Milford, C
  • I Always worry about what might happen ahead: implementing safer conception services in the current environment of reproductive Counseling for HIV-affected men and women in Uganda
    Matthews, LT; Bajunirwe, F; Kastner, J
  • Developing a safer conception intervention for men living with HIV in South Africa
    Khidir, H; Psaros, C; Greener, L
  • Application of an ecological framework to examine barriers to the adoption of safer conception strategies by HIV-affected couples
    Saleem, HT; Surkan, PJ; Kerrigan, D
  • Stigma gets in my way: factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda
    Beyeza-Kashesya, J; Wanyenze, RK; Goggin, K; Finocchario-Kessler, S; Woldetsadik, MA; Mindry, D
  • Health care provider perspectives on pregnancy and parenting in HIV-infected individuals in South Africa
    Moodley, J; Cooper, D; Mantell, JE
  • Delivering safer conception services to HIV serodiscordant couples in Kenya: perspectives from healthcare providers and HIV serodiscordant couples
    Ngure, K; Kimemia, G; Dew, K
  • “I may not say we really have a method, it is gambling work”: knowledge and acceptability of safer conception methods among providers and HIV clients in Uganda
    Finocchario-Kessler, S; Wanyenze, R; Mindry, D
  • Client and provider knowledge and views on safer conception for people living with HIV (PLHIV)
    Mindry, DL; Milford, C; Greener, L
  • “I don’t know if this is right…but this is what I’m offering”: healthcare provider knowledge, practice, and attitudes towards safer conception for HIV-affected couples in the context of Southern African guidelines
    West, N; Schwartz, S; Phofa, R
  • Lost opportunities to reduce periconception HIV transmission: safer conception counseling by south african providers addresses perinatal but not sexual HIV transmission
    Matthews, LT; Milford, C; Kaida, A
  • “We have to try and have this child before it is too late”: missed opportunities in client-provider communication on reproductive intentions of people living with HIV
    Mindry, DL; Crankshaw, TL; Maharaj, P
  • Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a safer conception counseling Toolkit in Kenya: stigma, fears, and recommendations for the delivery of services
    Mmeje, O; Njoroge, B; Akama, E
  • Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: results of a Phase II Study
    Mantell, JE; Cooper, D; Exner, TM
  • Antiretrovirals and safer conception for HIV-serodiscordant couples
    Matthews, LT; Smit, JA; Cu-Uvin, S
  • Community perceptions of childbearing and use of safer conception strategies among HIV-discordant couples in Kisumu, Kenya
    Breitnauer, BT; Mmeje, O; Njoroge, B
  • HIV-infected Ugandan women on antiretroviral therapy maintain HIV-1 RNA suppression across periconception, pregnancy, and postpartum periods
    Matthews, LT; Ribaudo, HB; Kaida, A
  • Reproductive decision-making and periconception practices among HIV-infected men and women attending HIV services in Durban, South Africa
    Matthews, LT; Crankshaw, T; Giddy, J
  • Correlates of Use of timed unprotected intercourse to reduce horizontal transmission among Ugandan HIV clients with fertility intentions
    Wagner, GJ; Goggin, K; Mindry, D
  • Challenges with couples, serodiscordance and HIV disclosure: healthcare provider perspectives on delivering safer conception services for HIV-affected couples, South Africa
    Crankshaw, TL; Mindry, D; Munthree, C
  • Incidence and predictors of pregnancy among a cohort of HIV-infected women initiating antiretroviral therapy in Mbarara, Uganda
    Kaida, A; Matthews, LT; Kanters, S
  • Fertility decision-making among Kenyan HIV-serodiscordant couples who recently conceived: implications for safer conception planning
    Pintye, J; Ngure, K; Curran, K
  • Beyond HIV-serodiscordance: partnership communication dynamics that affect engagement in safer conception care
    Matthews, LT; Burns, BF; Bajunirwe, F; Kabakyenga, J; Bwana, M; Ng, C
  • Assisted reproduction in the HIV-serodiscordant couple
    Nosarka, S; Hoogendijk, CF; Siebert, TI
  • Scale up use of family planning services to prevent maternal transmission of HIV among discordant couples: a cross-sectional study within a resource-limited setting
    Kuete, M; Yuan, H; Tchoua Kemayou, AL
  • Pregnancy intentions and safer pregnancy knowledge among female sex workers in Port Elizabeth, South Africa
    Rao, A; Baral, S; Phaswana-Mafuya, N
  • Application of an ecological framework to examine barriers to the adoption of safer conception strategies by HIV-affected couples
    Saleem, HT; Surkan, PJ; Kerrigan, D
  • Effectiveness of semen washing to prevent HIV transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis
    Zafer, M; Horvath, H; Mmeje, O
  • Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: a qualitative study
    Ddumba-Nyanzi, I; Kaawa-Mafigiri, D; Johannessen, H
  • Assisted reproductive technology in South Africa: first results generated from the South African Register of Assisted Reproductive Techniques
    Dyer, SJ; Kruger, TF
  • Predicting pregnancy in HIV-1-discordant couples
    Guthrie, BL; Choi, RY; Bosire, R
  • Now or never: perceived HIV status and fertility intentions in rural Mozambique
    Hayford, SR; Agadjanian, V; Luz, L
  • Consensus statement: supporting safer conception and pregnancy for men and women living with and affected by hiv
    Matthews, LT; Beyeza-Kashesya, J; Cooke, I; Davies, N; Heffron, R; Kaida, A; Kinuthia, J; Mmeje, O; Semprini, AE; Weber, S
  • Expanding HIV testing and linkage to care in southwestern Uganda with community health extension workers
    Asiimwe, S; Ross, JM; Arinaitwe, A
  • Testing and counselling: a systematic review and meta-analysis of community-based approaches. Sansom SL, ed
    Suthar, AB; Ford, N; Bachanas, PJ; Towards Universal Voluntary, HIV
  • Influence network agent effectiveness in promoting couples’ Hiv counseling and testing in Kigali, Rwanda
    Wall, K; Karita, E; Nizam, A
  • Promotion of couples’ voluntary HIV counselling and testing in Lusaka, Zambia by influence network leaders and agents
    Wall, KM; Kilembe, W; Nizam, A
  • Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia
    Kelley, AL; Hagaman, AK; Wall, KM
  • Sustained effect of couples’ HIV counselling and testing on risk reduction among Zambian HIV serodiscordant couples
    Wall, KM; Kilembe, W; Vwalika, B
  • Need to include couples’ HIV counselling and testing as a strategy to improve HIV partner notification services
    Joseph Davey, DL; Wall, KM
  • Improving HIV test uptake and case finding with assisted partner notification services
    Dalal, S; Johnson, C; Fonner, V

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