Toward the end of HIV transmission: Safer conception in the era of expanded biomedical HIV prevention

Advances in biomedical treatment and prevention have expanded available safer conception options for persons living with HIV. There is growing evidence that the use of ART to suppress viral load alone or coupled with the use of pre-exposure prophylaxis (PrEP) can virtually eliminate HIV transmission risk among serodifferent (also known as sero-discordant) partners. Since HIV-affected couples desire to have children, it is important that fertility requests be addressed and that safer conception is discussed as part of routine HIV care.

Shannon Weber served as the Director of the National Perinatal HIV Hotline, a free 24/7, expert consultation service based in UCSF’s Department of Family and Community Medicine. In this role, she managed the essential operations for providing direct access to experts for questions on HIV and pregnancy. She developed and continues to coordinate the comprehensive 280+ participant strong Perinatal HIV Clinicians Network rapidly linking pregnant women living with HIV, their exposed infants and HIV sero-different couples to appropriate care. She facilitates the ReproIDHIV listserv, a forum for clinicians, researchers and community-based organizations that serves as a highly-successful mechanism to disseminate clinical protocols and educational materials and mobilize advocacy efforts related to HIV treatment and prevention for women. She also directed the Bay Area Perinatal AIDS Center (BAPAC), the San Francisco General Hospital (SFGH) program providing care to pregnant women living with HIV and HIV-affected couples, which has now transitioned to HIVE.  Shannon launched the PRO Men (Positive Reproductive Outcomes for HIV+ Men) initiative, an innovative collaboration between BAPAC and SFGH’s Ward 86 HIV Clinic to integrate men’s reproductive and sexual health services into an HIV care setting.  Shannon is a workgroup member for the CDC’s One Test. Two Lives. initiative and serves on the CDC’s Elimination of Mother-to-Child HIV Transmission in the U.S. stakeholders group as well as on the Expert Panel on Preconception Care for HIV-positive women.

Shannon led efforts in northern California from 2005 – 2010 to implement rapid HIV testing in labor and delivery settings for women with no previous documented HIV test, as one vital tool in preventing mother-to-child transmission of HIV. When PrEP to prevent HIV transmission was proven to be highly effective, Shannon took on that issue with her heart and soul.  She led the effort at HIVE to incorporate PrEP into the reproductive options for sero-different couples seeking to become pregnant.

At the moment, Shannon is very involved with the San Francisco Department of Public Health’s commitment to virtually eliminating new HIV transmissions via its Getting to Zeroprogram, as a leader in PrEP access and implementation.  One of Shannon’s latest innovations for PleasePrEPMe.org is, to offer on-line PrEP navigation via live chat and phone access in both Spanish and English, as a means to expand access to PrEP, especially for those people most at risk for HIV, including young gay and bisexual men and transgender women of color. Shannon’s cutting edge work has caught the imagination of experts at the CDC, and she is now funded to expand PleasePrEPMe.org nationally to include PrEP providers in other states in a searchable database.