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 Jose. Thanks for your comment. I don’t understand why you think you have been positive for 9 years if you only just tested last year. It is good news that your children were not affected. Luck does play a big part in all this :)
I have HIV 9 year without knowing I had three children who are HIV negative during those year without any treatment I just found out I was positive this year I guess I’m lucky
The results in from the recent PARTNER study showed that almost 900 sero-different couples had sex more than 58,000 times without using condoms – and without a single case of HIV transmission.
You can speak to your husband’s clinic about possible use of PrEP. This is taking just 2 HIV meds – often in a single pill – to protect against HIV.
But if your husband’s viral load is undetectable the risk of HIV transmission is close to zero.
However, there are cautions. Using condoms can protect you against HIV if your husband’s viral load unexpectedly rebounds. They can also protect against STIs – and prevent pregnancy of course.
My husband he is HIV positive for 7 years but on treatment. And I’m negative should I take medicine before we have sex.
Hi, Congratulations on the news that you’re going to have a baby. And no, it isn’t too late. Late diagnosis is defined as after 28 weeks of pregnancy. But if this happens to you, there is plenty that can be done to help you have a negative baby.
It’s important to start HIV treatment (ART) very quickly so that you get an undetectable viral load by the time of delivery. Please talk to the clinic about starting ART that can get your viral load to undetectable as soon as possible.
You can find out more about HIV, women’s health and pregnancy in this guide:
http://i-base.info/guides/pregnancy
Best wishes, Roy
Hey I am HIV positive and I found out when I was 19 weeks pregnant and my CD4 was 137, isn’t to late for my baby to get infected
I’m hiv positive my wife. Is hiv negative so now I don’t want to infect my wife we want a healthy baby free from virus infect both mother annd baby
If viral load is undetectable see this:
http://i-base.info/qa-on-the-partner-study
Also this:
http://i-base.info/guides/pregnancy/what-to-do-when-one-partner-is-hiv-positive-and-the-other-is-hiv-negative
If viral load is detectable, PrEP will ensure you do not catch HIV.
http://i-base.info/uk-guide-to-prep/
Hi i have a question im hiv negative but my boyfriend is hiv positive with low count viral load i we want to have a baby but im not sure ifnis safe for us im taking truvada prep pill and he takes his hiv pills can some one please let me know if is safe to have unprotected sex to get pregnant but he has a low viral load?
Hi, Today, HIV treatment (ART) is safe and effective. And ART works for everybody. It has reduced HIV-related deaths and illnesses in countries all over the world. Getting tested can help stop you worrying about your status. You can ask the doctor about getting support while waiting for the result.
You can find more information about ART here:
http://i-base.info/guides/starting/does-art-really-work