Question
Can an HIV negative woman and her HIV positive partner conceive naturally?
16 January 2018. Related: All topics, PEP/PEPSE, Pregnancy, Sero different couples.
My boyfriend is HIV positive and I am negative. We have unprotected sex regularly and are interested in becoming pregnant the old fashioned way rather than using the sperm washing method.
– What are my chances, percentage wise, of catching HIV?
– How often should I get tested?
– How long does it take for the infection to be detectable?
– Will my baby be at risk?
– Will the baby automatically be HIV positive?
– Is this a very ignorant choice?
– Should I take the medications as well as a precaution?
– Also, is my three year old daughter who lives with us at risk? What should I do to keep her safe?
– What are safe viral load counts for him to have?
I feel very confused, but I love my boyfriend and enjoy our sex life. Please answer these questions and ease my anxiety a bit.
Answer
Thank you for your questions. I shall try and answer them one at a time.
Modern HIV meds are so effective that they also protect your partner. Spermwashing has not been needed or recommended for many years.
What are my chances, percentage wise, of contracting HIV?
An HIV negative woman and an HIV positive man can conceive naturally.
This can be done through limited conception attempts during the most fertile days of your cycle. i.e when you are as ovulating.
If your partner has an undetectable viral load on treatment (ideally for a few months), then the risk becomes zero.
The PARTNER study reported zero HIV transmissions after about 900 couples had sex than 58,000 times without a condom when the positive partner had an undetectable viral load.
For more information on HIV and natural conception, please follow this link on HIV and pregnancy and this link on the Swiss Statement.
How often should I get tested and how long does it take for the infection to be detectable?
For information on HIV testing and the window period [time between exposure and when infection can be picked by an HIV test], please follow this link
Will the baby automatically be HIV positive?
As you are HIV negative, the baby will be HIV negative.
Will my baby be at risk?
Your baby can be at risk if you become HIV positive whilst pregnant and your viral load is very high. Returning to using condoms after you become pregnant might still be a good idea, even when your partners viral load is undetectable.
A high viral load is one of the main risk factors for transmission. If viral load is detectable, there is a higher risk of catching HIV during pregnancy.
Transmission to the baby can occur at 3 stages, but only if you become HIV positive.
- During pregnancy
- At the time of delivery
- Through breast-feeding.
However, there are interventions to reduce the risk of transmission to the baby during pregnancy and birth. These include:
- Taking treatment so that viral load is undetectable by the time of delivery
- Giving the baby a course of treatment for the first 4 weeks of life.
For more information please follow this link.
Is it an ignorant choice?
This is not an ignorant choice. Many thousands of couples in your situation have children naturally. Luckily treatment now dramatically reduces the risk of transmitting HIV if this process is done carefully.
However, it is important that both you and your partner make an informed choice. It is recommended that you discuss your options with your doctor.
Should I take medication as a precaution?
Sometimes PrEP [Pre exposure Prophylaxis] and PEP [Post Exposure Prophylaxis] are used an additional precaution. This involves taking a single dose of treatment before and after having sex.
PrEP is not likely to add much or any protection, because having an undetectable viral load is enough. It might help for psychologically if you are nervous. PrEP is very effective too.
More information on PrEP is at this this link
Is my 3 year old at risk and what should I do to keep her safe?
Your 3 year old is not at risk as HIV is not transmitted from daily activity.
What are safe levels for my partner’s viral load?
The risk of transmission is so low when your partner has an undetectable viral load that is it generally thought to be close to zero.
Note: This question was updated in January 2018 and September 2016 from an original answer in September 2011.
Hi Anonymous, I am sorry to hear that your doctor is not helping. Have you been to speak with any other doctor/healthcare professional.
When you were told you had HIV did you have any tests done to confirm your status? and have you had any viral load/CD4 count tests?
Have you had your wife and kids tested?
Being given a diagnosis of AIDS does not mean you will die. Taking treatment for HIV and managing any other health conditions will lead to recovery of AIDS and you can continue living a healthy life.
HIV treatment is used to suppress HIV (viral load). When this is suppressed it allows the body to naturally recover CD4 count – this is a measure of your immune system. When it is low you can be given an antibiotic called co-trimoxazole to prevent further infections called co-trimoxazole.
Have you other issues that you have mentioned been treated/managed? and how is your family coping with this news? Have you been able to speak to anyone or go to a support group to help deal with adjusting your life?
This is a link about starting treatment: https://i-base.info/guides/starting
Hi back in 2019 I had had an unprotected sex with prostitute and never got it tested for all sti after that..I went through so many illness for the next 3 years and I didn’t have any clue it because of one of unprotected sex which I had in 2019..I went to hospital one day with multiple issues there they diagnose me with Aids and now my wife and all children has aids..I made a very big mistake having sex with prostitute…Now my entire family has aids ….we are told that doctor cannot help us at all we will eventually die…
Hi Blue,
Your partners status won’t have any impact on your child. If a baby is going to contract HIV it’ll be from their mother.
There’s info here about how to protect yourself as well as your baby:
https://i-base.info/guides/pregnancy
Hy
Im blue
I am HIV positive an 4 months pregnant … my partner tested negative an we having unprotected sex is my baby safe from transmission?
Hi Oke,
The simple answer is yes.
When someone has an undetectable viral load they can’t transmit HIV, please see here: https://i-base.info/u-equals-u/
My husband viral load is less than 20 can I get pregnant for him and still be on the safe side.
Hi Sadiq,
On this occasion your doctors are wrong, your wife doesn’t need to take PrEP as there’s no risk.
ok but doctors told me that ur wife will use prep
i am from Pakistan 23 years old .single but going to marriage next months and she dont know about my status
Hi Sadiq,
It’s great to hear that your viral load is 37copies ml, what this means is that your HIV is under control. It also means that you can’t transmit HIV when having sex without a condom. Please see here: https://i-base.info/u-equals-u/ What this means is that there’s no need for your wife to use PrEP.