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 Drunk,
If your boyfriend has a detectable viral load, then you are at risk of contracting HIV. Only condoms will prevent this. If your boyfriend is on medication and has an undetectable viral load, the risk will be close to zero. For more info please see the results of the PARTNER study:
http://i-base.info/qa-on-the-partner-study/
Because his diagnoses is new, it may be better to wait until his viral load is undetectable before planning to have children. However, the risk is up to you.
Hi my boyfriend is HIV positive. I’m negative. The thing is he wants a child while he is still very healthy. Even though we found out he was positive, this year January he has not accepted his status. He wants to have unprotected sex with me and we’ve had it four times. What are my chances of being infected?
Hi Nicky, so long as you are HIV negative, your baby will not have HIV. Nearly all the risk comes from the mothers HIV status, not the father.
I am 24 weeks pregnant and iam hiv negative but conceived from my hiv positive husband, we discussed this with our doctor before trying to conceive, my doctor tested my again and am still negative,we always use a condom, so can my unborn baby be at risk?
Hi Megwa,
I’m sorry, but I don’t understand the quesiton. If your girlfriend is negative and you already have a child, then why would you think you could be infected with HIV?
my girlfriend is HIV negative, and she want me to have sex with her without use of condom. We have a baby of 1 yr and 6 months, can we marry each other, can I be infected with HIV, I don’t known what to do pls help me.
Hi Sid,
Because you’ve got an undetectable viral load the risk of you transmitting HIV to your wife is close to zero. Please see the results of the PARTNER study for more info:
http://i-base.info/qa-on-the-partner-study/
Therefore, in theory you can choose to have sex without a condom as many times as you like.
Hi i am HIV+ and my wife is negative. I am on undetected viral load from last 2 years. My CD4 count is almost 1500. We planned to have baby. Although i know using ovulation period for unproted sex is the better option. But i am confused how many times we shoud try without condom within this period. Do we need this every day or for limited time. Please help?
We tried last month for a week and had sex unrotected for 5 to 6 times. Is it too many try?
Hi Lizzy,
Finding out that you’re HIV positive can be a shock. More so if you’re pregnant. This can be worse if you don’t know how you contracted HIV. Or, if you think you contracted HIV from a partner and they won’t test.
With regards to testing, you can’t force someone to have a test. If they don’t want to test then you have to deiced what it is that you want to do.
You can’t change the fact that you’re positive. Therefore, you need to think about what’s best for your health and that of your babies. Are you on meds? Are you able to get support?
If you’d like more info on HIV and pregnancy, please see here:
http://i-base.info/guides/pregnancy
I’m 20 weeks pregnant and tested positive. I met my partner a year and half ago. I’m not sure of his status. A day after I was diagnosed I dragged him all the way to the clinic for the tests unannounced and surprisingly he refused to go for the tests. What should I do? Is it possible that he was already HIV positive when I met him?