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.
An HIV test is accurate 3 months after the last time you had unprotected sex. If you have tested negative after this period then you do not have HIV, and neither does your baby.
I just gave birth my baby boy is 3mnths I tested twice while I was pregnant they came negative. I’m no longer in a relationship with my baby’s dad but wen I called him recently he told me he’s hiv+ I last slept wth him while I was 3mnths pregnant I need to knw is it possible tht I’m still hiv-. I’m worried cos I’m breastfeedin my son
Hi Thembsor,
Congratulations on your engagement! There are lots of couples where one person is positive and the other negative. Many of these couples have healthy babies without passing HIV to the baby or the negative partner. Please have a look at these FAQs, and let me know if you have any questions!
I’m HIV-. I’m about to get married and my fiancee is HIV+. We want to have a child but I don’t know what should do. I’m really confused!
Hi Mashia,
Reinfection may be a concern if either of you has resistance to HIV medications. But if neither of you has any drug resistance there is very little risk. For more information please follow this link: When both partners are positive
Thank you Simon for your reply
The reason for the doctor to be discourage is that the might be reinfections, so we should wait untill it is undetectable. as for that might be too long because I don’t want to experience the issues of having a baby at my late 30yrs now I am 28 and my partner is 37.
Will the sperm wash be a best option for me, because as for now is all I hope for and I am in South Africa where that can only be done in Private Hospital
Hi
Whether you want to have a baby is a decision for yo and your partner to make. If this is what you decide, then it sounds like getting information and support from your doctor will be better. I am curious why your partner’s doctor was not so helpful.
If you decide to plan for a baby, the STI screening is easy and is strongly recommended. This is for the babies health in case there is anything you are not aware of that could easily be treated.
Hi
I am HIV+ and my partner also he been on ARV for sometimes now. I am verymuch healthy with a CD4 of 600 same as him. never done the STI screnning. but truelly willing to get pregnant. our doctor has been different. mine advie me to have naturally while his doctor discourage us so what will be a solution for us.
It sounds like the VCT centre gave you good advice. The ARVS could reduce the risk of catching HIV if the other person was HIV positive. It is probably easier and safer to continue taking the ARVs for the next 4 weeks, than trying to get this other man to have an HIV test. ARVs to prevent infection are the same drugs taken by HIV positive people to treat HIV.
Hi have been married for five years now without conceiving. I am HIV negative and so my husband. Recently we went to the national hospital to know what might be the reasons. It was confirmed my hubby has low sperm count so i decided to have sex without protection with a friend of his whom i trust. I told him we go to VCT, but we had sex but the man was bleeding very heavy blood. After i decided to go VCT alone and I tested negative but i told my doc wht happend n she introduced Arvs for protection juz incase the man had the virus. I’m so worried that if the man has no virus and i take ARVs what could happen to me? I am so confused.