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…I had sex with many people without protection since 2014…but I was diagonised as hiv negative in 2017…from then I continued only with one person(a)…in recent months I had sex with another person(b) with protection and also with (a )sometimes with protection and sometimes without protection…1 week back person(a) got diagnosed with hiv positive and Me with negative…how can person(a) get positive even after me having safe sex with person(b)
Hi Nomusa,
Short answer: absolutely yes, you can have a child, but your partner needs to use HIV treatment (ART). So you should be able to get help from his clinic or doctor.
When your partner’s viral load is undetectable you can have sex without condoms to conceive naturally. That’s because if you’re undetectable you cannot transmit HIV, even if you don’t use condoms. Here’s the link to Undetectable = Untransmittable.
Please see question 6 here.
Here’s the guide to HIV pregnancy and women’s health.
We want to have a child, i am HIV negative and he is HIV positive, where we can go to get help
Hi Claire,
It’s good that you tested HIV negative. And it’s great that you’re encouraging your partner to start HIV treatment (ART).
Here’s a link to Undetectable = Untransmittable (U=U). U=U shows why it’s a good idea for your partner to start ART. Having an undetectable viral load on ART means that your partner will not be able to transmit HIV. Even if you don’t use condoms.
You can decide when is the right time to tell your family. Having more info can help if you want to tell other people. So here’s the guide to ART in pictures.
I’m dating this man for almost two months now. we once had unprotected sex, after that I force to an HIV test and he tested positive I myself tested negative when should I do the next test. But I’m encouraging him to start treatment as soon as possible.
Have loved him so much I don’t know what to do. Disclosing to my family is some kind of difficult.
Hi S.A,
It’s good that you’re on HIV treatment. Do you have access to your viral load and CD4 count results?
If your viral load is undetectable the risk of HIV to your partner is zero, even if you don’t use condoms. For more info please see U=U (Undetectable = Untransmittable).
However, if he has blisters he should see the doctor about them to get a diagnosis, and possible treatment.
I’m positive and my partner is negative we have sex without condom it’s been I’m on treatment will he be positive cos he refuse to use condoms and lately he has blisters and he refuse to go to the dr
Hi Sindy,
It’s good that your partner is taking ARVs. And it’s great that you’re supporting him each and every day.
It sounds good too that he’s taking ARVs. Because if he has an undetectable viral load the risk of HIV to you is zero. Having an undetectable viral load, that means under 50 copies/mL, means HIV cannot be transmitted even if you don’t use condoms.
There’s more info here on U=U (Undetectable = Untransmittable).
And here’s the guide to HIV pregnancy and women’s health.
Thank you for you advice my partner told me that he tested HIV positive and i also go and test i tested HIV negative and we are using condom during sex but i was scared that i’m i going to have children without be infected with the desease and i dont want to live my partner because he was honest to me. and he take his ARVs and i makesure that i support him each and every day.
Dear Ntomby,
I’m so sorry to hear the sad news about your fiance. Please accept my sincere condolences.
I’m also sorry to hear about your recent diagnosis. Testing HIV positive can be a shock for everybody. And being 26 weeks pregnant as well can make it a tough time.
However, late HIV diagnosis in pregnancy is at 28 weeks. But even if this happened to you, there is plenty that can be done to help you have a negative baby.
So starting HIV treatment (ART) immediately can help to get an undetectable viral load by the time of delivery. That can help dramatically reduce the risk of HIV to your baby.
Once you start ART your viral load can reduce by 90% in the first few days.
Results from your viral load test will take less than a week, and sometimes only takes a few days. So please can you talk to the doctor and ask that your viral load is monitored now you are taking ART.
Also, please can you check with your doctor about the the drugs in Triolar? All baby’s need to take a short course of HIV drugs for the first four weeks of life, if their mother is HIV positive.
Please see this guide to HIV pregnancy and women’s health.
Being on ART can protect your health as well as your baby’s health. It can help stop you from getting sick and that means you’ll be better able to look after your baby.