Rapid antiretroviral therapy initiation for women in an HIV-1 prevention clinical trial experiencing primary HIV-1 infection during pregnancy or breastfeeding

During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primaryHIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART), despite having CD4counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancyand breastfeeding is feasible in this setting.