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 Rudi,
Please talk to a doctor about these sores. Your partner’s ARVs will not be causing this and it is important to find out why you are getting these.
It is very unlikely that your partner’s HIV meds would cause a reaction in you.
You need to see a doctor about this.
My HIV positive partner & I have unprotected sex. She takes ARV’s. Im developing sores allover my body. Can the cause b the ARV’s she is taking
Hi Xoli,
The risks of reinfection are similar to the origional risk of catching HIV. This is much lower than most people think, and is much less when you are both on treatment. So long as you are both adherent to treatment the risk is very small, although it is still present. The main risk of reinfection is if one of your becomes resistant to your medication. You could then transmit this resistance to the other person, meaning your treatment would stop working. But again this risk is small if you are adherent to your medications.
Deciding on when to try to have a baby is a personal choice. If you are feeling fit and healthy this should be fine. This is something you can talk to your doctor about, and for more information please see our Guide to HIV, pregnancy and women’s health.
hallo, in 2011 i fell pregnant and on the 4th month i tested negative but i did not knw my partner was positive as he did not test at that tym, and we continued having unprotected sex. Then after 3mnths my partner told me He is positive. I tested again, and i was negative again. Is it possible that i might be positive and i gave birth through Ceaserean, is my baby also positive? Please help
hi
my partner and i are both hiv positive,he started treatment a year ago and i started 3 months ago,my cd4 count was 126 but was not sick…we have been using condoms eversince,what are the chances of us reinfecting each other if we have unprotected sex althought we are on arv’s…would you advise to also wait a lil long as we want a baby?
Hi Bellinda,
To be certain of his test results your husband would need to test 3 months after the last time you had unprotected sex. This is because of the ‘window period’ between infection and when the test can pick up your body’s response to the virus. This is explained here in our Guide to HIV testing and sexual transmission.
Im 21years of age & im HIV positive bt my husband is not but we have had unprotected sex for 1month & went 2 test & stil his negative could he have caught the virus?
Hello Yenni,
It is difficult to estimate the risk of you passing HIV to your boyfriend. If you are on treatment and your viral load becomes undetectable (under 50) the risk is much lower. But there is always some risk. This is explained here:Viral load and sexual transmission.
So far your boyfriend has been lucky. HIV is not that easy to catch, especially when you have a low viral load. But it is still possible that he could become infected. It is up to both of you to decide whether you want to continue to have unprotected sex, with this information in mind. For more information about having a baby when you are positive and your boyfriend is negative please take a look at this similar question.
I am HIV positive but my boyfriend is not. We have had sex without condoms numerous times and he came bck negative. My CD4 count is 468 and my viral load is 333 what are the chances of him getting it because we want to have a baby in the future.