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.
Hello I’m 34 years old lady and I found out that I’m HIV possitive and so scared of starting my medication I’m scared of the side effect, please help
Hi Sam,
It’s great to hear that your HIV treatment (ART) is working well and keeps your viral load undetectable.
So the simple answer to your question is, Yes! You can plan for a baby naturally with your wife. That’s because if your viral load is undetectable on ART, you can not transmit HIV. Even if you don’t use condoms. And this can protect your wife and your baby from HIV.
There’s more info here at Undetectable = Untransmittable (U=U).
I m 26 years HIV positive male since last 2.5 years. I have undetectable viral load since last 1 year continuously can I plan for a baby naturally with my HIV negative wife? My CD4 is 850
Hi Hilda,
Giving oral sex to a woman is likely to be zero or close to zero risk. Vaginal fluid, even if infectious, is more difficult to get in your mouth compared to cum.
It’s good that you’re on HIV medication. If your viral load is undetectable you can not transmit HIV even if you don’t use condoms.
Please see this link to Undetectable = Untransmittable (U=U).
My partner is HIV- , m on medication, can he be infected while sucking my vagina?
Hi Raz,
If your viral load is undetectable, you can’t transmit HIV. Please see here: http://i-base.info/u-equals-u/
Hi. I am a male hiv positive from last 6 years I am undetectable for all this last 6 years since I started my treatment
Now I need to marry hiv negative lady I want to have unprotected sex 100 percent all time with zero time using condom is that safe for her and for future baby
I don’t want to use condom just to have normals unprotected sex like negative man
Can that happen ?
Hi Veena,
Is this the result on an HIV test? Please see this Q&A.
Some tests (not in the UK) include a number with the result. If the number is higher than 1.0 it means you are positive. If the number on your test is less that 1.0 it means you are negative.
What is 1.1 level hiv? Is it positive and if yes which stage it is ? And how long a person can live with perfect medication and diet from today with 1.1 level
Hi Veena,
Please see this link for all FAQs for HIV risk and HIV testing. Unfortunately we don’t have resources to anwser more questions on this. But you’ll find most answers on the link.