Benefits of PrEP as an Adjunctive Method of HIV Prevention During Attempted Conception Between HIV-uninfected Women and HIV-infected Male Partners

摘要: Background. Data on effectiveness of preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV)– uninfected women attempting conception with HIV-infected male partners are limited to observational studies. Methods. To explore the benefits PrEP conception, we developed a model estimate average annual probability woman remaining HIV-uninfected and having child (“successful” outcome) via condomless sex an male. The outcome likelihood is dependent upon parameters defining HIV-1 infectivity. We simulated 2 scenarios: optimal (condomless acts ovulation window), suboptimal (acts not ovulation). Results. Inthe scenariowhenthe maleisonantiretroviral therapy (ART),the averageannual probabilityof thesuccessfuloutcomeis29.1%,increasing 29.2%withtheadditionofPrEP(P=.45).Inthe scenario,the 26.8% ART alone versus 27.3% ART/PrEP (P<.0001). Older maternal age reduces success in both scenarios, particularly after 30. Conclusions. In our model, provides little added benefit when partner ART, tothe window, andother modifiabletransmission risks optimized. female decreases by increasing number required conception.