Question

How can we have an HIV negative baby?

7 August 2006. Related: All topics, Newly diagnosed, Pregnancy.

The question is this, I have been having unprotected sex with my partner for the past 4 years up until now when I was diagnosed positive. She tested twice negative after my test. Both of us were mystified. Sometime last year she fell pregnant, but miscarried. We have a healthy, negative daughter. We are planning to have a second baby. I discussed this with my doctor and who assured me that it is possible to have a negative baby. He however, advised me that I should start treatment to get my viral load undetectable then try. I told him this could be risky for my partner but he said if I had uprotected sex with her in the past without infecting her how will I infect her now. My CD4 is 360 and was planning to start treatment once about 250. Confused.

Answer

Answer: Simon Collins

Your email raises several questions.

First of all it may help to look at the i-Base guide to HIV and Pregnancy.

A lot of information here relates to how to safely have an HIV negative baby. Most importantly, if the mother is HIV-negative, and does not become HIV-positive during the pregnancy, the baby will always be HIV-negative.

It is also worth discussing your personal situation in terms of risk of HIV for your wife. Although your partner is negative now, this doesn’t mean that she could not become HIV-positive in the future. She may have a stronger immune system against HIV, but with time, and increasing exposure, it would be very likely that the virus would infect her at some point if you don’t use condoms in the future.

Given that you have not been using condoms for the last four years, then not using condoms in order to conceive a baby, probably is a very low risk for your partner now, but using condoms afterwards is important. The risk could be as low as 1 in 1000 for example for each exposure, but over time then it is more likely that she will become infected.

You could reduce the risk to zero by using a specialist process called ‘sperm-washing’ which is available on the NHS, but this also has a lower chance of successfully conceiving. More information aboujt this is available in the section of the guide on planning a pregnancy.

Whatever you decide is a personal decision that you both have to be both happy with.

In this respect, your doctor is giving you good advice about going on treatment. By going on treatment now, the levels of HIV will be reduced in your semen, and this will make the chance of transmission even lower. And for your own health, there is not much difference between you starting now on when your count falls a little lower. Starting a little earlier may even have benefits for you by reducing the risk of side effects. There is no evidence to suggest that your treatment presents any risk to your wife.

More detailed information about your treatment is included in the i-Base guide Introduction to Combination Therapy.

I hope this information is useful but please get back if there are other questions we can help with.