Project 415452

Millions of men and women living with HIV around the world want to have children and an estimated half have HIV-uninfected sexual partners. For the majority, achieving pregnancy involves condomless sex, presenting risks of HIV transmission to uninfected partners and infants. A range of available safer conception strategies can support individuals and couples to meet reproductive goals with minimal HIV risk. These strategies include sustained use of antiretroviral therapy with viral suppression by the partner living with HIV and/or pre-exposure prophylaxis (PrEP) by the HIV-uninfected partner, which can eliminate HIV transmission risk during condomless sex. While increasing attention has focused on improving access to safer conception care for women, much less is known about the needs of men. In 2018, we launched a pilot safer conception clinical program in a rural district of Uganda and recruited men living with HIV who reported wanting to have a child in the next year with an HIV-serodifferent pregnancy partner. Our preliminary findings revealed a strong demand, need, and retention in safer conception care. After sharing preliminary findings, community and government leaders in Uganda emphasized three critical next steps: (1) support and enhance engagement of people living with HIV in the research, consistent with the GIPA and MIPA principles; (2) assess 18-month outcomes of men who enrolled in the safer conception program; and (3) pursue future applications in the area of HIV and STBBI research, grounded in community-based research principles. Thus, the overall goal of this proposal is to foster a collaboration between Canadian and Ugandan research and community stakeholders to catalyze community-based research capacity in male-inclusive safer conception research in rural Uganda. With a commitment to reciprocal learning, we will leverage Canadian expertise and experience in community-based research to inform safer conception research and clinical care in Uganda.