Studies have shown that the use of antiretroviral medications as part of antiretroviral treatment (ART) has significantly prolonged the life expectancy of those diagnosed with HIV. According to data from 200 clinics in Europe, the United States and Australia, ARTs were implicated in the reduction of HIV-related death rates from 18 per 1000 individuals annually between 1999 and 2001 to nine per 1000 annually between 2009-2011.

The new hope provided by ARTs has enabled HIV-positive individuals to carry on with life as normally as HIV-negative individuals, including fostering healthy relationships. The emergence of serodiscordant couples, where one partner is HIV-positive while the other is HIV-negative, has brought about questions exploring the impact of ARTs and pre-exposure prophylaxis (PrEP) therapy on pregnancy outcomes.

A new study was conducted of 1785 female participants at nine different sites across Kenya and Uganda. The participants were HIV-negative, and were part of serodiscordant relationships where the male was HIV-positive. 598 women received tenofovir disoproxil fumarate while 566 women received emtricitabine/tenofovir disoproxil fumarate and 621 women received a placebo. Upon detection of pregnancy, the medication being administered was discontinued.

Results showed that 431 pregnancies were reported, with the incidence of pregnancy reported as not varying greatly between the PrEP groups and the placebo group. The study found no significant modification in pregnancy outcomes or incidence for participants in the PrEP groups versus participants in the placebo group. Pregnancy loss incidence was also similar between the PrEP groups and the placebo group.

The study concluded that PrEP posed no major concerns for preterm births, birth outcomes, congenital defects or infant growth throughout the first year of life for children of PrEP group participants. As the PrEP treatment was stopped immediately after detection of pregnancy, the study could not comment on the safety of PrEP during the conception phase.

The authors of the study indicated the necessity for the results to be communicated to serodiscordant couples who are concerned about their status affecting their ability or willingness to get pregnant.