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 Dladla,
Your baby would only be at risk if you were positive. Because you aren’t then your baby wouldn’t have been at risk.
I tested HIV negative whilst my husband tested positive and I was breastfeeding at that time. I want to know if my baby could be in danger.
Hi Jane
Just try and support him and give him his space and time. That’s all you can do. He may need to come to terms with his status and he may be concerned about you.
I simply can’t accept de fact dat my partner is positive. he claims he got de infection from previous relationship.. that I believe him. my question is how do I get him to stop bieng insecure about me because am negative and he is not. for he think il leave him becuase of his status
Hi Unknown,
Sperm washing is an option. However, this is quit complex and isn’t always offered to couples. The best thing to do would be for him to start treatment. Once he’s on treatment and his viral load becomes undetectable, the risk of transmission to you will be close to zero. This means that you can conceive naturally.
I need assistance..I want a baby but my partner is HIV positive. I’m negative. He’s not on medication. What can we do?
Hi Nqobie,
If your fiance has a detectable viral load and your having unprotected sex, you could still contract HIV. This is even if you’re so far tested negative. This is because up to now you’ve been lucky. If you aren’t have unprotected sex, then there isn’t any risk to you or your baby.
Until your fiances viral load is undetectable, that is if it already isn’t, its very important that you use condoms. This is more important due to you being pregnant.
I tested negative for hiv about 7 months ago but my fiance was too scared to test with me at that time. We have been having unprotected since we have been together. I am currently 5 months pregnant. And have recently found out he is hiv positive and yet i still remain negative after having done the test again. He only has been having sex with me and claims he contracted the virus from previous relationships which is why he was reluctanct to go test the first time i asked him to. How is possible that i am negative and yet he is positive, since he impregnated me? If further test still prove that i am negative does that mean both me and the baby are in the clear hence he wasnt aware of his status and was not taking any medication to get his viral load to be undetectable.
Hi Linda,
I can’t tell you how to tell your partner. However, you could try and find out what his thoughts are about HIV.
If you’ve had an undetectable viral load the whole time that you’ve been having sex with your partner, the risk of transmission is close to zero.
If however, you haven’t been on medication, then yes there is a chance that he has been infected.
I am HIV positive my partner does not know i am pregnant he wants to get married I am afraid of losing him please assist. Can he make me pregnant and still be negative