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 Grace,
I am very sorry to hear about your husband’s diagnosis, and also about the loss of your child. This must be a very difficult time for you both. Do you have any support to help you deal with this?
Couples where one person is HIV positive and the other is negative can usually conceive naturally without infecting the negative partner, so long as the positive person is on treatment with an undetectable viral load. There is more information about this here.
Please read the info at that link and let me know if you have any questions.
Hi there! My husband has been tested hiv positive 4month ago and same time he get tested they put him on medication,we have been together 3yrs and last year was pregnant and I get birth this year february and all my pregnant I was getting tested all the time I will visit the clinic. So I think my husband hs been hiv positive for so many years back without knowing. And my baby was very healthy and I was very happy for that, Unfortunately my sons passed away in August just a sudden death he just take morning nappy and never wake its really pains me a lot after all this happened.
Now I want to have a baby again but I mite be not so luck this time and get infected am so worried and I really wsant the baby conceiving naturally,when is the good tym for us to have a baby, I really love my husband and I don’t want to get infected
Plis help
Hi Praise,
Please see this page in our guide to HIV testing and transmission for information about this.
I have been undetectable for 6months my girlfriend is negative but doesn’t like condom, is it safe to have unprotected sex?
If either of you has HIv or another STI then you there is a risk this will be passed to the other partner. If neither of you has HIV or another STI, and you don’t have other partners, then the only reason to use condoms would be as birth control.
I do unprotected sex wid mi husband daily and we are very happy with each other. i want to know that , is there any chances that we will be HIV positive…??? we never use any precaution. plz let me know…????
Hi Daniel,
I’m sorry to hear about the problems you are facing. It’s important to respect your girlfriend’s concerns and work together to learn more about HIV transmission so that you can both feel comfortable when you do have sex. Our guide to testing and transmission explains the risks related to sex when somebody is HIV positive. This includes information about condom use. Why not read through the guide together so that you both understand how to protect each other? If your girlfriend is still unhappy after looking there she might be able to access counselling from the HIV clinic about how to enjoy an active sex life while staying protected.
My girlfriend she is afraid to have sex with me because I’m HIV positive and she is HIV negative,I am 100% sure that we can use condom but she say is not safe.What must I do
The risks are likely to be very low because for two reasons:
i) because your viral load has been undetectable for three years, and
ii) because the mouth has fairly good barriers against HIV.
If there was a lot of blood, or if your girlfriend has ulcers or bleeding gums this would increase the risk. This would be a reason to have a check up even thought the risks are still low.
Almost 3 nights ago. I was engaging normal sex with my girl friend. But she accidently bit my tongue. I stop and cleaned with tissue and continued having protected sex. I am HIV postive and she is negative. I am also undetectable for the past 3 years.
What are the risks tat I infected her. Please advise asap.
Thanks.