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.
Hey I am + and my boyfriend is – few months back when I went for blood tests my viral load was undetected . But I’m afraid cause I don’t know how log it stays that way. And my boyfriend has this tendency of not using a condom when we start having sex. Im afraid to tell him, I’m just not ready. But I’ve told him constantly that we should use protection.
Am how risky is this??
Hi Ruth.
Your boyfriends viral load is detectable, therefore you’re at risk of contracting HIV. You’re going to need to test.
my boyfriend is possetive and is not under treatment he has detactable load and we a having u protected sex what are the risk of getting hiv
Hi Tyneisha.
No you won’t get sick if you have sex without a condom. However, unless your viral load is under control, so less than 50 you risk infecting your partner if you have sex without a condom.
I’m HIV positive my boyfriend is HIV negative but he had an ex girlfriend that was HIV positive they been broke up for a year and some months ago and he haven’t had sex since then ,will I get sick if we have unpretected sex
Hi T boss,
I’ll answer your questions in order.
1: The level of a persons CD4 count isn’t related to their viral load. A person can have an undetectable viral load even when their CD4 count is in single figures. The main thing is that people are on medication. If you’ve been on meds for more than 3 months, which you have then ideally your viral load should be undetectable. A test will confirm this.
2: Its very unlikely that you’ll get any opportunistic infections, this is because your CD4 count is very high. As to how your health will fare in the future its not possible for anyone to predict this. Please see here: http://i-base.info/guides/side
3: This will all depend on the status of your partner. If they are positive then there’s no reason why you can’t try for a child now. However, if they are negative then I’d wait until you know what your viral load is.
Hello my CD4 is 1209 on 17th December 2018 after 4months of treatment,my cd4 was not tested before I started treatment and my viral load test will be done in d next 2month.my question are.1 with such high cd4 count can I assume am undetectable because I feel so healthy and stronger? 2 with such strong cd4 if I continue with strong adherence to my drug will I suffer any HIV related illness in d future? 3 can I try for a baby with my partner now or should I wait for viral load test before we try because were are free from STDs.
Hi Junior,
HIV is not transmitted by kissing, including deep kissing. Please see this link for other ways HIV is not transmitted.
You can get HIV with kiss I am asking
Hi Zane,
It’s great that your viral load is undetectable. What HIV meds are you taking? They sound as though they’re working well. Having an undetectable viral load means that HIV cannot be transmitted even without using condoms. Please see much more info on Undetectable = Untransmittable at this link.
So, the good news is, you can have sex with your boyfriend without using condoms. The only caution at the moment is that it’s recommended to be undetectable for 6 months before relying 100% on U=U. But this is a very cautious approach. Guidelines are likely at some point to become more relaxed about waiting for six months. As doctors get more confident about U=U, guidelines are likely to reduce this to three months or one month in the future, or for one undetectable result in blood to be enough. Simon has answered this question in detail on this Q&A.