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 Phillemon,
It’s great that you’ve already started ART. Getting your viral load to undetectable will protect your partner and your baby. It’s really good that, while you wait for ART to reduce HIV to undetectable, you’re using condoms.
1. Your baby is safe because you are using condoms and your partner is HIV negative.
2. As your partner is negative she does not have to take treatment for the baby.
3. HIV negative mothers are free to breastfeed and don’t need to make special arrangements.
4. There are no special options if she remains HIV negative up to the time the baby is born.
Once you are undetectable you and your partner can try for another baby because U=U. Please see this link Undetectable = Untransmittable.
Hi
I (male) tested positive last month and my partner is negative and she is 8 months pregnant. we are a discordant couple. she has been testing negative everytime she goes to antenatal clinic since January.
I recently started taking treatment (ART).
1. is the baby safe?
2. must she take treatment for the baby?
3. will she breastfeed the baby and for how long?
4. what options does she have before and after giving birth for the baby?
we are now practicing safer (protected sex.
please advise we are stressing especially my partner.
Hi Anonymous,
As long as your boyfriends viral load is undetectable there isn’t any risk. Please see Q14 here for more info:
http://i-base.info/qa/what-are-the-most-asked-questions
Hello,
My boyfriend recently realised he is HIV postive, we have been having unprotected sex and on the 14th of February 2018 I tested negative. I tested again on the 1st of May 2018 the result was still negative and I was told to re-test again on the 1st of June.
He takes his medication everyday he has been taking it for about 4 months now, we want to continue having unprotected sex however the medication he is taking states that it doesn’t lower his chances of infecting anyone through sexual contact.
Please advise which medicines can he take that could help us? Do I have to be on medication also?
Hi Juliet,
Many HIV positive women safely have children with HIV negative partners. Taking HIV treatment (ART) and having an undetectable viral load means you can’t transmit HIV to your husband. So, the good news is, you can conceive naturally. You can read more about HIV, pregnancy and women’s health here.
Am positive and my husband is negative. How can i concieve without having sex with my husband
Hi Victoria,
An HIV person on meds with an undetectable viral load can not transmit HIV if they don’t use condoms. So it won’t make a difference if the man comes inside a woman. You can read more here about U=U (Undetectable = Untransmittable).
if a HIV man on medication make love to a HIV nagetive woman but did not come inside you will you still be infected
Hi Victoria,
If your husband is on medication and undetectable, he can not transmit HIV if you don’t use condoms. Here is the Partner study with zero HIV transmissions after couples had condomless sex more than 58,000 times.
my husband tested HIV positive and his on medication why his wife tested negative so he made love to me three days ago with out condom but promise not to come inside me and did not come pls will i get infected?