PrEPception: Expanding Assisted Reproductive Options for Serodiscordant Couples

Based on CDC's guidance on PrEP as well as results of randomized controlled trials, the U.S.
Food and Drug Administration (FDA) approved this daily medication (comprised of one pill) to
reduce the risk of sexually acquired HIV in adults at high risk. Other medical practices to
avoid transmission within this population include assisted reproductive technologies such as
sperm washing (or donated sperm) coupled with in vitro fertilization, intracytoplasmic sperm
injection (an in vitro procedure where a single sperm is injected directly into an egg), and
intrauterine insemination (placing the sperm directly into the uterus). However, these
methods are costly and often regionally scarce. PrEP is more accessible and a less expensive
option for couples. When used consistently and as prescribed, PrEP has shown to
significantly reduce the risk of HIV infection among adult men and women. However, risk
reduction counseling and clinical monitoring are necessary for its effective implementation.
Therefore, beyond efficacy trials, it is important to conduct additional studies of
pre-exposure prophylaxis to observe what factors make PrEP feasible and acceptable to
couples, as well as identify other factors that impact level of adherence. The study will
take place in four U.S. cities: Boston, Baltimore, Philadelphia, and San Francisco and will
involve couples who have chosen to begin PrEP for conception as part of their clinical care
after receiving preconception counseling and reviewing their options with their health care
provider.

Inclusion Criteria:

- Between the ages of 18 to 40 years

- In relationship with HIV-positive male

- Chosen to take PrEP for conception after completing counseling with health care
provider

Exclusion Criteria:

- HIV-positive

- In relationship with HIV-negative female

- Partner has chosen to take PrEP for conception after completing counseling with
health care provider