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 Amandu
Septrin will not to anything to reduce the risk of transmission. Now that you know you are HIV positive, your recent partners should also take a test, if you were not using condoms.
If your partner is HIV negative, then condoms will protect them from HIV.
After being on HIV treatment for a few months, this will dramatically reduce the risk of transmission, even without a condom.
Hello, I am HIV positive am on Septrin and if I have unprotected sex, can i transfer HIV to my partner?
Hi Cecile
The decision to start treatment is usually based on your boyfriend’s CD4 count. This is the result of the first blood test he should have after finding out he is positive.
If he starts treatment, he should use a combination where all three drugs are active against both HIV-1 and HIV-2. Some drugs – including the family called NNRTIs – are not active against HIV-2.
This treatment for him will also protect you from infection. Until then, you can use condoms which are very effective.
Life expectancy is now so good with meds, that in general, people are advised to plan for the same active life they had before they found out about HIV.
See this guide for more info on treatment:
http://i-base.info/introduction-to-combination-therapy-2014/
My boyfriend first blood test was detected to have HIV 1 & 2 and now he had the confirmatory test for HIV. If he had HIV positive what medicine and treatment he has to take? And how many times he have to take it? I’m very lost I love him very much but I’m too afraid because my blood test is negative but will I in future will possibly get HIV positive? If he get treated with medicine and treatment how long can he live? I’m very worried I don’t wish to see him dead or anything happened.
Why not try to talk about this with your husband. It is difficult to comment otherwise. If your husband is on treatment there are lots of studies that also shows HIV is difficult to transmit. This may help if either of your are worried about intimacy because of HIV.
We have been married for 9 years; on our 2nd year of marriage we discovered that my husband was HIV+ and I was HIV- even though we had unprotected sex. We have been using condoms for the past 7 years but we seldom have sex. This makes me feel guilty as I assume he has lost interest due to the use of condoms. At times I feel like we should continously have unprotected sex as I feel I am being too impossible and unreasonably strict……I am confused as I love my man and would like to see him happy also I love my life.
Hi Alfred
Please see this link to the results from the PARTNER study.
http://i-base.info/htb/24904
The PARTNER study report zero HIV transmissions within about 800 couple and after more than 44,500 times when a positive partner had sex without a condom when they also had an undetectable viral load.
Hi, I am in relatioship with an hiv positive woman and i am nagative i love her so i wna if we take our relationship 2 de next level. She says she needs a child next year and i also do so hw is de risk of there will i be positive too?
Because your question is so important, I have posted this as a new question with the answer here:
http://i-base.info/qa/10174
Any new comments should be posted to this new question.
Hi dr, please help as me and my fiance are planning to have a child but the problem my fiance is positive and I am negative. He is taking his ARVs and his CD4 count is increasing. He said he spoke to one of the nurses in clinic and he was told that he can do unprocteted sex as he is CD4 count is increasing. I am really scared. What if me and the child that we planning gets an infection. Pls help as we really desparate for a child.