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 Lily,
Can you tell me which country you live in? You can also have a look at our pregnancy guide which has information about natural conception.
Hi,
Im one of the women who haveHiv + partners. He’s been on ARV’s since 2005. We have a 10 year daughter but want another child.In January this year his viral load was tested and results came undetactable. We tried artificial insemination where his sperm was washed as well. We did that in 2011 and 2012. Im a bit tired almost throwing a towel, even risked recently. Do you know a doctor we can go to who can give us an advice on what we want should we go the natural way ? I asdked my Gynaue and his physicial they both said they dont specialise with AIDS cases and cannot relly give us a fair recommendation
Hi Frans, please see our testing and transmission guide for information about condom use.
can couple have sex without condom , if yes what are disadvatage
and if no why,
Hi Mashia,
I’m sorry to hear that you don’t have any support to deal with this. I do recommend contacting TAC as there are many other HIV positive women in South Africa who can share experience of similar situations with you.
As I mentioned before, unless either you or your boyfriend has drug resistance then there is relatively little risk of attempting to conceive naturally. And if your boyfriend’s viral load is undetectable you could try self-insemination if you are uncomfortable with having unprotected sex.
Please do look carefully at our pregnancy guide to decide whether you think sperm-washing is the best option for you and your boyfriend.
Hi Rebecca McDowall
Thank you very much with your respond. Most of the time I feel lonely am just alone going through this pain. My partner is one person who can’t express his feelings. Lucky he got me to talk to most when he is down as for me I sometimes feel that he don’t care much about our baby situation, or he feel is a man he must accepted that he is sick he cannot have children and then he avoid this subject.
I now made a doctors appointment to help with the artificial insemination (SPERM WASH) I am willing to pay every cent. And they promised me that it is not going to be as costly as I ever thought it as. For 1st consultation is R1000.00 to do the insemination is R5000.00 and Sperm wash will cost me R1200.00. I hope all goes well
Hi Mashia,
I’m very sorry to hear how stressed you are. Can I ask if you have any support to help you when you feel worried? You may find it helpful to join a support group in your area to meet other HIV positive people. Because you live in South Africa you could contact the Treatment Action Campaign for information about support in your area.
Many couples who are both HIV positive try to conceive naturally- through having sex without a condom. This is because reinfection is only a risk if one partner has extensive drug resistance and a detectable viral load, or neither partner is on ARVs. This should be the only reason that a couple should be discouraged to attempt to conceive naturally. Reinfection is even less likely if you only have unprotected sex a few times in order to conceive a baby. You can read more about this in our pregnancy guide.
I am a little concerned that you say your partner is on treatment but has a detectable viral load. How long has he been on treatment, and what is his viral load? If his viral load is not undetectable after 6 months on treatment then there is a higher risk of drug resistance.
Good Day Good People
I am not okay at all and always felling terrible about my situation.
I’ve been +ve for the past years 3yrs of my knowledge and until now my CD4 is always high recent one 517 with a viral load of 4300 six months ago was 579 with a load of 3000.Hypertities B tested negative
I need to start a family I have one daughter age 9 and I feel I need two more children.
My man is also willing but because he is on treatment with a detectable viral load we always use protection.
Our doctor says we should not try until our viral loads are undetectable.
I am not on treatment or vitamins. My health is very well.
How can I really have a baby without waiting too long and without new infection?
My man is 38yrs and I am 29 waiting is not working for me.
Please help my heart is swore I cry anytime when I think about the fact that this may take me three to four years for me to be on treatment, and for my viral load to be undetectable, I can have a baby with a man over the of 40 please help it has to be this year. And have another baby a year later.
Please help I am not fine about this at all.
Hi Sandra,
I’m very sorry to hear about your situation. Please follow this link to our testing and transmission guide for information about when to test and questions about sexual transmission.
Hi There,I met my boyfriend 6 months ago and things went so quickly between us. He ended up moving into my place and we didn’t use condoms all the time. 3 months later I realised I was 6 weeks pregnant and we both agreed on an abortion as I have a 2 year old child and he also has 3 kids aged 8,2 and 1 with different mothers. I then tested negative immediately after my abortin and now I find out that he is actually HIV positive.He is not on treatment and he says his CD4 count is 600 so what are the chances that I am infected and when must I go for another test? Please help, I am so devasted.