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.
My viral load is undetectable and my boyfriend is negative I like to know if we can have sex without condoms
Hi T boss,
Great – 6 kids sounds like a really good target to aim for!
2. Here in the UK we are tested every six months. For most of us the result continues to be undetectable.
3. People living with HIV who are on ART can have a similar life expectancy to people who are HIV negative.
3. Scientists are working very hard, please see here. And now there are more studies with new treatment.
4. Many HIV positive people need time to get used to the idea of being HIV positive. It’s difficult to stop thinking about it at first. But it sounds like you’re already thinking about your future life.
Thanks for your response pls I want to kwn if I can have up to 6kids or more with my condition as an hiv+ man because my parents wants me to have as many kids as possible because we have a small family and we have all it take to take care of them. 2. if am adherent to my drugs and becomes undetectable and still continue been very much adherent to my drugs, how often should I have a viral load test in a year? 3.what should b my life expectancy with undetectable viral load? 3.pls scientist should work harder and find a cure for dis infection.4 what can I do to stop thinking of my status every single day even while am asleep I still dream about it.thanks
Hi Vee,
I hope that you and your baby are doing well.
There are many couples were one partner is HIV positive, and the other is HIV negative, even when they haven’t been using condoms. Please follow this link for more information on such cases.
And Angelina has answered a very similar question here. I hope this helps.
hi.i have been with my boyfriend for four years…when I was 7 months pregnant my result came back positive while everytime wen i tested it was negative .its now 9months he frequently test but he still become negative am there when he draws blood for testing .I’ve never cheated…he even thinks the baby is not his and that i’ve cheated on him ..i am soo confused plz help
Hi T boss,
Many countries were screening for HIV in blood for transfusion by 2006. But you can ask at the clinic when Nigeria started this. And HIV is not transmitted by sharing hair clippers.
Hi sorry I forgot to mention dat I had a major operation in 2006 which I can’t remember if I had blood transfusion cos I was unconscious but my mom said she can’t remember if I had a transfusion. And also is it possible to get infected in d process of hair cutting because when I was in high school all d boy in d boys hostel used one clipper without sterilizing. I can’t really point out wen I got infected because av never gone for HIV test in my life am 29yrs old.
Hi T boss,
It’s great to hear that you two are so much in love. And there’s very good news. . .
1. It’s great that you’ve started treatment. Once your viral load is undetectable you can start to plan having kids.
2. Sometimes people live for many years without knowing they have HIV, and they don’t have any symptoms.
3. It’s a good idea to have a test for HIV antibodies, which are produced by your body. And for HIV antigen, which are parts of HIV that can be detected in the test.
4. There are reasons why sperm can look watery. Generally, there is nothing to worry about. Neither HIV, nor HIV meds are likely to be causing this. Being more watery does not affect your ‘sperm count’. You are perfectly fine and just as likely to have a baby, no worries.
5. You can ask at your clinic if your fiance can take PrEP while you’re starting HIV treatment (ART) and until you’re undetectable.
6. U=U is real and reliable. Please see the Q&A here.
So, yes, it looks like your dream can come true. There’s more info on U=U at this link.
Hi I never knew I was HIV+ until 10th September 2018 wen I went for general screening with my fiance in respect of our wedding next year we ve dated for 3yrs and never had unprotected sex, she tested hiv- and I HIV+ with a very faint positive line on the test we were not convinced and went to another center were it still came up very faint positive again and we were told that dis infection is still new and not up to a year in my system and I have never cheated on my fiance, I don’t do drugs, I don’t smoke.my question are 1. Av been on treatment since then and my fiance still want us go ahead with d marriage i love her so much and she loves me too can we live together with out her been effected and have kids for me? 2.is it possible that my I was infected 8yrs ago by my ex girlfriend and never had a symptoms since then and looks and feels very healthy. 3.if its possible y is d test line very faint and d control line very clear. 4. Since I started my treatment I notice my sparm became watery compared to how thick it used to be and my fiance is worried if I can ever get her pregnant.5. We live in Nigeria abuja is prep available in Nigeria. 6 is d u=u real and reliable because we endured using of condoms for 3yrs that we are going to stop it wen we are married,pls can dat dream still come to past or are we going to continue with condoms forever except wen we want to conceive a baby.pls am worried and confused at d moment I can’t stop thinking about d every single day.
Hi Sne,
It’s a good idea to talk to your husband and doctor about this. If you are HIV negative it’s not possible that your baby will be positive. If your partner has been on HIV treatment for 4 years it’s likely that his viral load was undetectable when your baby was conceived. That means you and your baby were at zero risk of HIV.