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 fiance just passed away a month ago and that’s when I only find out that he was HIV positive and im 26weeks pregnant then I went for my test to my shock I’m now HIV positive too,test results on my viral load is 9910 and CD4 count 562 my Dr prescribed Tribuss tablets but my medical support team sent me Triolar tablets and antiviral syrup to give too my baby for 6week after birth for treatments, is it not too late for my treatment to protect my baby,am I going to give birth to a HIV healthy negative baby and am I not going to get sick after giving birth to my baby that I can not even take care of it? Please help worked mom
Hi Prudy,
Do you mean you just misssed the 2 last days? If you’ve been on treatment for 4 years and are undetectable then there might not be viral rebound. So your boyfriend and baby will not be at risk if you’re still undetectable.
This can be the case if you’re taking a version of Atripla, such as Tribuss or Odimune. These drugs stay in the body a bit longer than other HIV meds.
What does the doctor say? You can ask for another viral load test to make sure you’re still undetectable. You can check your viral load before you try to conceive.
Do you have access to your last CD4 count and viral load results? Please let us know and tell us what HIV meds you’re taking.
I have on treatment for almost 4years now missed my treatment for 2 days and i need to know can i have unprotected sex with my boyfriend and also get pregnant with out infecting him or my baby
Hi Jay,
If the guy’s viral load is undetectable, there’s no risk. Please see here: http://i-base.info/qa/what-are-the-most-asked-questions
Had sex with a guy unprotected, he told me he is hiv undetected, works out everyday and never misses a day of medication. I fell ill days after, should I worry or is this just probably a normal sickness that has nothing to do with me being exposed?
Hi Kokoza,
If you’re on treatment and your viral load is undetectable, there’s no risk. Please see here: http://i-base.info/u-equals-u/
I am a lady who is HIV positive for 11 years this year, I have unprotected sex and my viral load is on level and I’m on treatment.
Hi Lexy,
There is good news for couples if one partner is HIV positive and the other is negative. There’s a lot of info at this link.
It’s great that your partner has been on medication for 3 years. That’s because to conceive naturally the HIV positive partner should have an undetectable viral load for six months. Although six months is likely to be cautious and in future it could be reduced.
But is there a problem with access to viral load results? Knowing your viral load results is important to make sure that your HIV medication is working well.
It’s great that you’re timing condomless sex with your partner’s most fertile time. Here’s the guide to HIV pregnancy and women’s health for more info.
Please talk to the doctor about viral load results.
I am married to woman who is HIV+, she has been on medication for the past 3 years. We have never had unprotected sex until today because she’s ovulating and we are planning to make babies naturally. I just want to know if I am at risk of getting HIV. She has never checked her viral load ever since she started medication.
Hi Andy,
If your viral load is undetectable then there isn’t any risk of transmission to your boyfriend. Please see here: http://i-base.info/u-equals-u/
Unless you have issues with your medication, your viral load should remain undetectable.