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 Parveen,
If your husband is on medication and his viral load is undetectable then you can have a child the normal way. This is because there is no risk of transmission to you. Please see here: http://i-base.info/u-equals-u/
If his HIV isn’t under control you could use sperm washing, this however is expensive and isn’t offered everywhere. The ideal is for your husband to have his HIV under control.
My husband is hiv positive iam negative I want a baby with him with out transmission of HIV me & my baby can it possible by artificial fertility treatments like IVF & isci plz give me hope & Ur valubal suggestion for my life..
Hi Queen,
As I’ve said, if your partner’s viral load is undetectable and he’s taking the meds the right way, there is no risk to you even if you don’t use condoms. And yes, you can have a child by conceiving naturally.
Here’s the guide to HIV, pregnancy and women’s health for lots of info.
And here’s the link to info about Undetectable = Untransmittable.
What chances do I have since my partner is + and am negative. I have run some test the last one was last year and am afraid to do it again although he releases his sperm on me when am avulating after that he uses condom and we want to have a child. Please I need help
Hi Queen,
One answer is that your man should be on HIV treatment (called ART). ART should reduce his viral load to undetectable and this will protect you from HIV even without having sex with condoms.
It’s important you talk to the doctor if your womb is not the way it should be. I don’t understand about being penetrated from the back side. But it’s important you talk to the doctor about this too.
Please I need answers. My man is HIV+ and am negative though he did not tell me initially he was having it. I have done some test about it am negative the last I did was last year and I do it once am afraid to do the test again b. He only release on me when am on my ovulation period. We want to have a child and my womb is not on the way It should be ,I was instructed that when he wants to release it should be from my back side so that it can penetrate. To my womb Am confuse is there any chance of having it
Hi Suman.
U=U is based on the best scientific data that there is. Put simply if you’re on medication and your viral load is undetectable, you CANNOT transmit HIV when having sex. Please see the following link: http://i-base.info/u-equals-u/
Well with undetectable viral load i really wish to have a baby when my spouse is hiv negative. But the prob lies here in india that no doc assures 0 percent risk of transmission even within limited time of intercourse. We are getting a huge set back. Is there any chance of transmission even with undetectable viral load or is u=u seems to be only a hypothetical data only?? Please guide us. We both are from india.
Hi Vicky,
Kissing, sucking and using condoms is very low risk. And if your partner’s viral load result is undetectable the risk is zero – even if you don’t use condoms.
You can read more about Undetectable = Untransmittable here at U=U.
Hi my woman is hiv positive and on hiv medication/drugs. i use condom whenever i have sex with her. we kiss deeply and she sucks my penis. can i contact hiv.