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 Thandiwe,
Guidelines about whether to breastfeed or not are different in different countries. Can you tell me where you live?
am currently takin septrin and zivovudine. Can i breast feed the baby exclusively 4 six months or i will be risking?
Hello,
If you are trying to have a baby it is important to find a way to discuss your HIV status with your partner. If he is not positive there is a risk he could become infected if you are having unprotected sex. Please follow this link to the THT website for information about how to talk to loved ones about your status.
I’m afraid I can’t help with your question about early menopause. This is something you would need to talk to a doctor about.
A man friend I met 20 yrs ago has come back in my life. I met him when I was negative and then 3 years later just went for routine medical check up and requested for STD tests and it came back postive . I suspect that when I met him 20 yrs ago he was infected but did not know or it was me who was infected but had a false negative . Kind of tricky really. we are so much in love as we rekindled affair but he has not mentioned anything about his status and neither have we talked about anything on those lines. Only thing I know he talks about going to doctors and getting blood works of all sorts. We are trying for a baby but how can I approach him so we both go for tests together. If it turns out that he is negative I dont want to lose him. This is like which is which situation or who infected who situation. Thanks in advance for solving my dillema. My periods are lost for 2 years ( early menopause) how can I induce ovulation and induce menstruation naturally without using more chemicals in my body.
Hi Sandy,
Because your husband is not currently on treatment you would risk becoming infected if you tried to conceive naturally.
Our pregnancy guide has information about sperm washing
IVF would only be needed if either yourself or your husband has fertility problems.
How much these procedures cost depends on where you live and the health care system in your country. Your local fertility clinic or HIV doctor should be able to advise you about this.
My husband is Hiv + and iam Hiv-, he is not on medication just vitamins and his CD4 count is 520,his viral load was 10 000. we would like to have a baby,im 35 and my husband is 36years old. we have been advised aboat 3 methods
natural way
sperm washing
IVF
from other people”s question you have already covered the natural conception of sero-discordant couples
can you please explain to me the the process of sperm washing and IVF and the cost of each procedure
Hi Hlangi,
For information about having a baby when your wife is HIV positive please follow this link to our pregnancy guide
thank you for the last response, i have a problem of being intimate with my wife as am worried of the viral load and and infection rate, she is finally on treatment and its 2 months now. i tested negative and we would like to have a babv
Hi
It is probably good to talk to your doctor about your plans for a baby. During pregnancy you CD4 count drops a little, so it might be better to wait a little to see how this increases over the next few months. This might put you in a stronger position in terms of your own health.
As you have just started treatment there will be plenty of time – and great news that you and your partner have these plans.
My partner I are both positive. He started his ARV’s 4 years ago and I started mine 3 months back. My cd4 count was 187 when started ARV’s, his is more than 1000. We had unprotected sex 3 times. We would like to have a baby. What are chances? Is it safe to try now or wait till my cd4 goes up?