When the man is HIV-positive and the woman HIV-negative
When the man is HIV positive with a negative partner, if they decide against timed intercourse, protected by ARVs, as described, it is possible to use a process called sperm washing.
This involves the man giving a semen sample to a clinic.
A special machine then spins this sample to separate the sperm cells from the seminal fluid. (Only the seminal fluid contains HIV; sperm cells themselves do not carry HIV).
The washed sperm is then tested for HIV.
Finally, a catheter is used to inject the sperm into the woman’s uterus.In vitro fertilisation (IVF) may also be used, especially if the man has a low sperm count.
There have been no cases of HIV transmission to women from sperm washing.
The disadvantages of sperm washing are cost, access and lower rate of conception.
Very few clinics offer this service in the UK but the clinic with the most experience is the Chelsea and Westminster Hospital in London. The Chelsea and Westminster assisted conception unit can be contacted on 0208 746 8585.
It is not always possible to obtain this procedure on the NHS, but occasionally people were funded as part of a risk reduction intervention at this clinic.
Apart from the cost, one of the disadvantage of sperm washing is that is does not have a very high success rate for conception, compared to conceiving by having sex. It is very safe in terms as far as preventing HIV transmission is concerned, but it also means you will be conceiving your baby in a very medicalised environment. Many people find this difficult, especially if it does not lead to a successful pregnancy.
As the information about safe conception protected by ARVs makes it more acceptable for couples to use this method of conception, sperm washing is being recommended and used less and less.
I am HIV positive. My partner is HIV negative.
We have two beautiful daughters. Both conceived naturally. Both, like their mum, are HIV negative
We initially considered spermwashing, but we would have needed to use artificial insemination. This was extremely expensive and involved travelling and giving my partner hormone injections.
This was not the the way we wanted to have a baby.
We decided that the risk of transmission with someone who was undetectable for many years, extremely adherent and had no STIs was very low.
So we bought a cheap ovulation test and did it naturally… and it worked… twice!
Mauro, Italy