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.
If your partner is HIV+ it makes sense to find out your HIV status. You could easily be positive or you could easily be negative. Probably there is a higher chance that you are still HIV negative and so finding this out now means you can use condoms so your risk stays very low.
You do not have to become HIV positive in order to have a baby.
If you decide you want to have a baby then it would be safer for you and your baby if your husband started HIV treatment. After the treatment has been working for about six month, his doctor can talk about the safest way for you to become pregnant. Your husband should want to protect your health and the health of any children you have together in the future.
What does your husband say. If this is not something he will talk about then talk to your own doctor or go to see a doctor to talk about this.
Hello my husband is HIV +. I only found after we have had unprotected sex several times. Now he wants a baby and I’m scared to go get tested but I really would love to have a baby what should I do? please help.
Had to give feedback, went for my HIV test and it came out Negative and I believe we all need a wake up call and this was it for me.
Thank you for being there, may even be involved in some HIV/AIDS campaign the first weekend of August but thank you for your blog and I like that its helpful and to the point keep up the good work.
Thanks Simon i test every 3months not that i engage in reckless behaviour but for the first time in my life am scared to test. Will give you feed back after the 1 of June.
Hi Tshepiso, there is nothing in my answer that was meant to be judging you and I am sorry if you thought this.
We gets lots of posts where someone is worried about they have HIV from a risk they have taken and where they then want to take the other person for a test. Sometimes this is even forced on the other person. There are complicated reasons why another person might not take an HIV test and this is for them to decide.
I was trying to separate out that after the risk has happened, you can only focus on your health for the future. You can only know whether you are HIV positive by taking your own test.
Including an HIV test as part of routinely looking after sexual health is easy and should be considered by anyone is is sexually active and who is not already HIV positive.
Waiting for test results may be stressful because you worry about the outcome. I hope that my answered also reassured you that the risk from any single exposure is likely to be low. Even if your partner was HIV positive the chance is more than 99% that you would not catch HIV from a single exposure.
Simon i get you and I dont think i need to be judged cause as I mentioned I know what to do but like any other human whose in my position am scared…. Just need to prepare my mind as to what to expect.
You do not have the right to make another person take an HIV test.
As long as you are an adult, you are responsible for your own sexual health and for the decisions you make when you agree to have sex with someone. Even if you think you were vulnerable, your anxiety now is related to the decisions that you made.
This risk of catching HIV from one exposure is generally low and your partner did not come inside you, but you need to take your own HIV test. The other person’s HIV status is no longer important to your health.
I believe i had sex with an HIV person but he refused to take a rapid HIV test with me. I was to late to start on PEP and we had unprotected sex though he didnt come inside of me the was still precum. He found me at a stage which i vunerable and from what i have heard it seems like hes intentionally spreading the virus. its been 4weeks and a couple of days but now am scared to test, i know asking this question may seem stupid but what are my chances of contracting HIV through precum? havent had any symptoms of exposure but thats not reliable and he lives meaning that if a person had an undectable viral load it lows the risk. Am so educated about this virus but i have never been so scared in my life. please help.
Hi Buyiswa,
HIV itself shouldn’t stop you from conceiving. If you have been trying for four years it is probably worth talking to a doctor about checking whether there are any problems to do with your or your partner’s fertility. You can also have a look at our pregnancy guide for information about the best time to try to conceive.
Hi
My patrner is hvi positive and I am not. We have been tying to concieve since 2009 naturally with out any success. Any advice that you could give?
Regards