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,
It is great that you are planning to have a child. Many sero-discordant couples (where one partner is positive and one is not) have HIV negative babies. Many choose to do so through unprotected sex.
If your husband is on treatment his viral load should drop relatively quickly until it is undetectable. At this point the risk of HIV being transmitted is significantly reduced.
You can find more information about having a child here:
http://i-base.info/guides/pregnancy/man-hiv-positive
My husband is hiv positive and I am negative, his cd4 count 850 and viral load is 70. We are planing for a child. If we plan to have it naturally is there any chance to transmit the virus to me. I am from india, is there any alternative method? pls provide me those details.
This guide to HIV and pregnancy includes information about how to have a baby when one partner is positive and the other is negative.
http://i-base.info/guides/pregnancy
my cd4 count is 1130 viral load is 46 my boyfriend cd4 is 160 viral load is 3 we want to have a child please help
Hi Gus,
Because you have been undetectable on treatment for more than 6 months, with no STDs, it is very unlikely that your wife would be infected if you have sex without a condom. The risk is likely to be zero, or close to zero. In the UK you it’s likely that a doctor would recommend that you should try to conceive naturally and that your wife does not need to take any medication to protect herself from infection. It’s a good idea to have sex during her most fertile period to increase the likelihood of conception but you will probably have to do this more than once to be likely of her getting pregnant.
There is lots of information about this in our pregnancy guide here. Please look there, and then let me know if you have any questions.
Dear all,
I am a 33 yrs old positive man for almost 5yrs. I am on atripla for the past 3,5 yrs and I am undetectable for the last 2 yrs and my cd4 counts 855(last results 11/9).My wife is 33 yrs also and hiv negative . He have not any sexual transmitted diseases. He have only once unprotected sex in our common 4 yrs life with ejaculation inside because we wanted a child. No pregnancy was successed and my wife is still negative after one year of this(she took 2pills Truvada). Now we want to try again this way because the Ivf we tried caused her hormon problems.but this time she don t want to take Truvada.this make me very anxious about transmitte the virus to her. How safe is this. We use ovulatory test and we plan to have only one intercourse. Thanks in advance for your time !
am hiv positive and i take medication for two 2years, also i take prevention pils for 1 and half year. for 9 months now am try to get pregnant but i can not, please can i get pregnant or how can i get pregnant?
Hello,
I am sorry to hear about the difficulties you are having conceiving. ARVs are not linked to problems with fertility so it’s a good idea to discuss this with your doctor and ask to be referred to a fertility specialist. Try not to worry too much though, about 80-90 % of couples trying to conceive are successful in the first year, but some can take longer.
Hi Jules,
Hepatitis B can be transmitted through unprotected sex so it is important that you are also tested for Hep B, and if you are negative you should ask to be vaccinated against this infection. If you do also have hepatitis B it is important to know this because it can be transmitted from mother to child so any future baby would also need to be vaccinated. You can read more about Hep B here.
Is your husband on any treatment for HIV or for hepatitis B?
Once you have been vaccinated against Hep B, or if you are already positive it is likely that conception would be the same as for any other sero-different couple. There is information about this in our FAQs. It’s very important that you discuss this with your husband’s doctor though so that you can protect your own health and that of your baby.
hie there.my husband is hiv+ and im hiv -.we’ve been having protected sex since his diagnosis.he got sick a few days ago and he’s been diagonised of hepatitis b.just when were planning to have our 2nd child.the 1 child we have is hiv-.now i just wonder if its still going to happen for us to concieve naturally without him infecting me with either of the dieseas.even if im on PeP or if i take PReP..please help,i want to have mo than one child.