Pilot study empowers Kenyan women living with HIV to have children

With lifesaving antiretroviral (ARV) treatment becoming more available, people are living with HIV as a chronic disease. People whose infections are stable are focused on integrating in their communities and living full lives, including having children. In sub-Saharan Africa, women disproportionately represent the majority of new HIV infections. HIV status doesn’t change people’s reproductive desires—it’s estimated that 20-50% still want to have children.

Services that support safely becoming pregnant are limited in sub-Saharan Africa. PrEP, which helps prevent new infections in partners of people with HIV, is not widely available. Viral suppression, which makes transmission highly unlikely, is not guaranteed. A new pilot study conducted with Family AIDS Care and Education Services explored timed vaginal insemination and consistent male condom use for couples in Kisumu, Kenya, in which only the woman was HIV-positive.

Twenty-three couples used timed vaginal insemination. Eight became pregnant, with 6 live births and no HIV transmissions to the child or partner. The time it took for them to become pregnant mirrored that of couples who aren’t affected by HIV and have no evidence on infertility.

Patients reported ease with the procedures with support from clinical providers. The study provided focused instructional aids for the TVI procedures, education and counseling sessions for couples and dedicated clinical staff to support the couples. Overall, the process was acceptable to the participants, feasible and effective. The findings can apply to other low-resource settings to empower women with HIV with an affordable and accessible reproductive option. Future implementation studies can look at widespread integration of this approach as another step toward supporting couples in shared decision-making with a range of options to help them build their families.