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 Nhlanhla,
Because your viral load is undetectable you can’t transmit HIV to your partner. Therefore, you can try for a baby the normal way.
Good luck.
I’m an woman HIV positive and my partner is negative. My viral load is undetectable and i want to try for a baby with him without affecting him. How can that be done and how safe is it for him?
Hi Pretty,
Falling pregnant can be difficult for some people, but its not the ARVs that are causing this problem. Nor is it your status. If you’ve been trying for a while, you may want to think about seeing a fertility specialist. They should be able to help.
My husband and I are trying for a baby, nothing is happening.I’m on medication.
Hi Sthembiso,
Its common that people who’ve been having sex with positive people will be asked to test more than once. Though this can be very stressful its actually very important. Until she is given the all clear, you should use condoms.
I recently discovered I’m positive,I’m a male,then I let my partner know about it,cause we had several times having unprotected sex,she went to her doctor for HIV test,she tested negative, her doctor told her she must go back to him after three months to make sure that she still negative,and our relationship is kind of hectic right now.Thanks
Hi Dr Madan, if the mother is HIV negative, the baby is very unlikely to be HIV positive. I am not a doctor and i-Base only provides information about HIV. Perhaps this is something you could consult with a colleague paediatrician about. I am sorry not to be able to help further.
Very useful info.
I have a 2 yrs old male child as my patient.
He is the product of a Hiv+ male and Hiv- female.
The child is not able to walk because of weak legs. Rest all his organs are normal.
What can be the diagnosis and line of investigation and management.
hi. I am HIV positive and my husband is HIV negative. I have been on treatment for 8 months and he has been very supportive. my status affected our sex life and it is so frustrating. He now wants to go for another test and doesn’t want me to go with him.
Hi Sharon, HIV can be difficult for both partners, even if only one of you have tested positive. Talking about how you each feel can help you each understand each other. It might be that your husband wants to do this for good reasons until he is more confident about his own health. Even if you husband doesn’t talk, you can say how you feel about this.