A clinical practice guide: What HIV care providers need to know about HIV pregnancy planning to optimize preconception care for their patients

Abstract

This clinical practice guide has been developed to support human immunodeficiency virus (HIV) care providers’ use of the 2018 Canadian HIV Pregnancy Planning Guidelines (CHPPG) in their work with people and couples affected by HIV. HIV pregnancy planning has changed considerably in the last decade and requires a multidisciplinary team, and HIV care providers are often at the forefront of the team. It is, therefore, important to have clear guidance on how to provide HIV pregnancy planning care. This Clinical Practice Guide is intended for both primary and specialty HIV care providers, including doctors, nurses, and nurse practitioners. We have repackaged the 2018 CHPPG‘s 36 recommendations into five standards of care for ease of use. We have also included an initial algorithm that can be used with each patient to direct discussions about their reproductive goals. Pregnancy and parenting are increasingly normalized experiences in the lives of people and couples affected by HIV. While conception used to be a complicated decision, often heavily focused on minimizing the risk of HIV transmission, the current evidence supports more universal counselling and supports for HIV pregnancy planning. HIV care providers have a responsibility to be familiar with the unique considerations for pregnancy planning when supporting their patients. This counselling is critical to optimizing reproductive health outcomes for all people affected by HIV, including those who wish to prevent pregnancy.