Can an HIV-positive man still have children? If so, what is the risk to mother and child?
Question
Can an HIV-positive man still have children?
Answer
Thanks for your question which is quite complicated to answer.
Firstly, the risk of a baby having HIV is only directly related to the HIV status of the mother, not the father.
Many HIV-positive women are having healthy HIV-negative babies by using combination therapy (ARV’s) during pregnancy. This reduces the risk of transmission to the baby to less than 1%, if the mother’s viral load is undetectable when the baby is born.
So if your partner is also HIV-positive, this is how you can have an HIV-negative baby.
However, if your partner is HIV-negative, then what you are asking about how your partner can become pregnant without the risk of catching HIV.
Some specialist HIV clinics have assisted conception units where sperm can be treated (basically by being spun to separate the sperm (which doesn’t contain HIV) from the liquid in the semen (which does contain HIV). This process is called sperm-washing, and it is 100% safe for the woman in terms of protection from HIV, although the final conception rate is only 15-18%.
A more controversial option, is for an HIV-positive man to use HIV treatment to reduce his viral load to undetectable both in blood and semen, and then to use limited conception attempts at the most fertile days in the woman’s cycle. Conception can either be naturally (having gentle sex) or using self insemination. Most doctors can provide guidance on how to plan and identify which days would be appropriate.
Viral load in semen can be tested using the same viral load tests that are used for blood, and your hospital could advise on this. The additional safety from testing semen viral load is that approximately 10% of people with undetectable levels in blood, can have detectable levels in semen.
Artificial or self-insemination would reduce the risk of trauma during sex where a small tear could increase the risk of HIV transmission.
Continuing to use condoms at all other times is essential.
This is more controversial because there is a small risk of transmitting HIV. However, especially where sperm-washing is not available, there have been encouraging reports that this has been successful (in one report around 60 couples conceived without any HIV transmission). For many women who want to have children, this risk may be acceptable, but it can only be something that the woman decides freely.
If you are trying this, there may be an additional safety benefit from using 1-2 days of HIV-drugs to reduce the slight chance of infection even futher. Several studies are looking at whether using tenofovir and FTC (or 3TC) before exposure to HIV can be proctective. This is based on optimistic animal studies.
In this respect, some healthcare providers may be able to help with information and counselling, and others may be openly hostile to this approach.
The i-Base guide to HIV, Pregnancy and Women’s Health includes a chapter on planning pregnancies and is available online or in print.
Information on this website is provided by treatment advocates and offered as a guide only. Decisions about your treatment should always be taken in consultation with your doctor.
Hi Avishek, have you had a look at our pregnancy guide pages about this? As the question above explains it is possible for a couple where the man is HIV+ and has an undetectable viral load to try and conceive naturally through timed unprotected sex. It’s a good idea to get a doctor’s advice about this but you can read this page about why being undetectable reduces the risk of transmission, and this page about the best time to try to conceive, for more information. Please do let me know if you have questions after reading those pages.
i am a HIV+ person male, & last 5 yr my viral load is less detectble,my wife is normal, we need a baby in normal process, without infected my wife , please guide me?
Thank You !
Hi Jimmy,
Please see this page in our pregnancy guide and let me know if you have any questions afterwards.
i have four kids with my wife , she has always tested for hiv during pregnancy and the results are negative. Am hiv positive ,i suspect i got the virus 14 years ago before i met her because since then i have not had sex with any other person apart from her. Am on ART treatment my CD 4 count rose from 325 to 530 and still going on with the treatment. Am therefore considering sex without condoms as am on ART treatment in order to have a baby .Your advise please
It is usually a shock when one partner gets a positive test result and the other is negative. If your confirmation test in a few months is also negative, then you have been lucky. You can still have a baby together, but the safest way to do this is for your partner to be on HIV treatment. It will probably take you both a while to come to terms with HIV and to learn about your options. During this time you will need to use condoms to make sure you stay HIV negative. There is lots of information on this site about how to have a baby when your partner is positive and you are negative.
http://i-base.info/qa/faqs-on-having-a-baby
i resently found out my bf is HIV positive n we havent been usin protection bt i tested negative n we trying 2 have a baby is it possible that i remain negative
Dear So Scared,
Your husband should have straight with you from the beginning but we won’t get into that. My husband of 13 years is HIV positive and has been since 2004. Thankful he has been undetectable since 2006 and is doing amazingly well. I am negative for the virus. For the last could of years we have been unsucessfully trying to conceive by having sex and I am still negative. It’s a chance we take but with him taking his cocktail of medications as prescribed he remains undetectable and his “T” cell count is almost as high as a person who is negative for the virus. Rest assure that you and your baby are fine. I would suggest to get tested every 6months for your own piece of mind. As for your baby, have the baby tested once and that’s it. The baby doesn’t need any more testing cause he is not at risk for exposure. I hope this helps
Hello,
Thank-you for your email. I’m very sorry to hear how worried you are and I can understand that this must have been very shocking to you.
First off- if you are HIV negative then your baby will be negative. HIV can not pass from father to child, only from the mother. So if you are negative your baby will be too.
Secondly, if your husband has an undetectable viral load then this makes it much less likely that he would pass HIV to you. An undetectable viral load means that there is very little HIV in the body, and this means that it is much harder to transmit the virus. Studies in the last few years have described the risk of transmitting HIV between a heterosexual couple where the HIV positive person is undetectable as being close to zero. This is backed up by something called the Swiss Statement which you can read by on the AIDSMAP website.
If you were infected you would not have an undetectable viral load- this is only the case in people on treatment for HIV. But even with an undetectable viral load you would still test positive for HIV because tests look for the body’s reaction to HIV- not for the virus itself. Please see our guide to testing and transmission for more info on this.
From what you have told me it is almost certain that you and your baby are both HIV negative. It also sounds like you would benefit from getting some support to deal with this. Do you have anybody who can support you to come to terms with this shock?
I need some help… I just found out my husband of 2years is HIV postive and we have a 6 month old baby… I was obviously test during the initial pregnancy visit and again half way through and have been HIV negative, I just took an in home HIV test which also said negative. Through talking with my husband he said he is “undetectable” and has been since 2007 (when HE found out he was positive) So I need to know if he can have a child that is HIV negative?? If I have been negative for the the last 15months will I develop the virus too?? If his viral load is undetectable does that mean that his virus in me will be undetectable too?? I’m sorry for carrying on but I have just been hit with a ton of bricks and I’m mentally spinning out of control…. Please any help you could offer would be GREATLY appreciated :,-(