Evidence map›Paper›PMID 30840672›Full record

Trial reportPloS one2019

Empowering HIV-infected women in low-resource settings: A pilot study evaluating a patient-centered HIV prevention strategy for reproduction in Kisumu, Kenya.

Okeoma Mmeje, Betty Njoroge, Pauline Wekesa, Alfred Murage, Raphael O Ondondo, Sheryl van der Poel, Mary A Guzé, Starley B Shade, Elizabeth A Bukusi, Deborah Cohan and 1 more

Open access · goldAbstract readClinical TrialMulticenter Study
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.1field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. "Sexual and reproductive health matters · 2024
    Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Okeoma MmejeDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America.ORCID 0000-0001-5460-4932
Betty NjorogeKenya Medical Research Institute (KEMRI), Centre for Microbiology Research, Nairobi, Kenya.
Pauline WekesaKenya Medical Research Institute (KEMRI), Centre for Microbiology Research, Nairobi, Kenya.
Alfred MurageDepartment of Obstetrics and Gynaecology, Aga Khan University, Nairobi, Kenya.
Raphael O OndondoKenya Medical Research Institute (KEMRI), Centre for Microbiology Research, Nairobi, Kenya.
Sheryl van der PoelWHO/HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction), Geneva, Switzerland.
Mary A GuzéDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America.
Starley B ShadeDepartment of Medicine, Division of Prevention Services, University of California, San Francisco, San Francisco, CA, United States of America.
Elizabeth A BukusiKenya Medical Research Institute (KEMRI), Centre for Microbiology Research, Nairobi, Kenya.
Deborah CohanDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America.ORCID 0000-0002-8163-005X
Craig R CohenDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America.
University of California, San Francisco · USKenya Medical Research Institute · KEAga Khan University Nairobi · KEWorld Health Organization · CH

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 1988 to 2026
$93.6M
Reproductive Infectious Disease (RID) FellowshipT32AI065388 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COHEN, CRAIG R · 2007 to 2011
$781k
NIAID NIH HHS P30 AI027763NIAID NIH HHS T32 AI065388World Health Organization 001
6 · The paper itself

Abstract

backgroundFemale positive/male negative HIV-serodiscordant couples express a desire for children and may engage in condomless sex to become pregnant. Current guidelines recommend antiretroviral treatment in HIV-serodiscordant couples, yet HIV RNA viral suppression may not be routinely assessed or guaranteed and pre-exposure prophylaxis may not be readily available. Therefore, options for becoming pregnant while limiting HIV transmission should be offered and accessible to HIV-affected couples desiring children.

methodsA prospective pilot study of female positive/male negative HIV-serodiscordant couples desiring children was conducted to evaluate the acceptability, feasibility, and effectiveness of timed vaginal insemination. Eligible women were 18-34 years with regular menses. Prior to timed vaginal insemination, couples were observed for two months, and tested and treated for sexually transmitted infections. Timed vaginal insemination was performed for up to six menstrual cycles. A fertility evaluation and HIV RNA viral load assessment was offered to couples who did not become pregnant.

findingsForty female positive/male negative HIV-serodiscordant couples were enrolled; 17 (42.5%) exited prior to timed vaginal insemination. Twenty-three couples (57.5%) were introduced to timed vaginal insemination; eight (34.8%) achieved pregnancy, and six live births resulted without a case of HIV transmission. Seven couples completed a fertility evaluation. Four women had no demonstrable tubal patency bilaterally; one male partner had decreased sperm motility. Five women had unilateral/bilateral tubal patency; and seven women had an HIV RNA viral load (≥ 400 copies/mL).

conclusionTimed vaginal insemination is an acceptable, feasible, and effective method for attempting pregnancy. Given the desire for children and inadequate viral suppression, interventions to support safely becoming pregnant should be integrated into HIV prevention programs.

Indexed as

HIV-1Insemination, Artificial, HomologousAdolescentAdultFemaleHIV InfectionsHumansKenyaPatient-Centered CarePilot ProjectsPregnancyProspective StudiesViral Load

Identifiers

PMID30840672
PMCPMC6402674
OpenAlexW2921662161

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.