Evaluating safer conception options for HIV-serodiscordant couples (HIV-infected female/HIV-uninfected male): a closer look at vaginal insemination

Abstract

HIV serodiscordant couples represent at least half of all HIV-affected couples worldwide. Many of these couples have childbearing desires. Safer methods of conception may allow for pregnancy while minimizing the risk of sexual transmission of HIV. In serodiscordant partnerships with an HIV-infected female and HIV-uninfected male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.

Figure 1

Steps for vaginal insemination of semen: (1) on a fertile day of the menstrual cycle, engage in sex using nonspermicidal condom (water-based lubricated or nonlubricated condom) or semen can be collected from a clean cup after ejaculation. (2) Collect the semen with a plastic needle-less syringe from a condom or clean cup. (3) The female or male partner will insert the syringe with the semen as high as possible into the vagina, ideally immediately after ejaculation. (4) The female partner may lie down for at least thirty minutes after insertion. (5) Steps (1–4) may be repeated every other day during the fertile period.