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Reducing risk of horizontal and vertical transmission and addressing HIV\u2010related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre\u2010exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV\u2010serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV\u2010serodiscordant couples.<\/jats:p>","DOI":"10.7448\/ias.20.2.21331","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T20:28:13Z","timestamp":1489523293000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Achieving pregnancy safely for HIV\u2010serodiscordant couples: a social ecological approach"],"prefix":"10.1002","volume":"20","author":[{"given":"Haneefa T","family":"Saleem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjulaa","family":"Narasimhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A","family":"Denison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin E","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.06.086"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(12)39639-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500401"},{"key":"e_1_2_7_5_1","first-page":"S251","article-title":"Reducing HIV incidence in developing countries with structural and environmental interventions","volume":"9","author":"Sweat MD","year":"1995","journal-title":"AIDS"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000814"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328358bac9"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5148"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001019"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002099"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/587651"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2014.946385"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1153592"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111421"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0108150"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.16.1.18588"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415604091"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2015.1074652"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.924520"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2013.809147"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.920023"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2015.1112349"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4195762"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-11-3"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.1.19462"},{"key":"e_1_2_7_27_1","doi-asserted-by":"crossref","unstructured":"MacCarthyS RasanathanJJ FergusonL GruskinS.The pregnancy decisions of HIV\u2010positive women: the state of knowledge and way forward.Reprod Health Matters.2012Dec;Suppl 39:119\u201340. 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