If you would like to have a child when either you, your partner or both of you are HIV positive, your HIV status should not be a deterrent. With the assistance of a doctor measures can be taken to significantly reduce the risk of infection to both the negative partner and child.
Reducing The Risk To The HIV Negative Partner – If you and your partner are considering conceiving a child there are several options to minimize the risk of infection to the negative partner. The first step is to inform your doctor that you are considering pregnancy and discuss the ways in which the risk of transmitting HIV can be reduced.
Your doctor can discuss your options thoroughly with you and your partner so you can make the choice that is safest and best for you.
Treatment As Prevention – We now know that if an HIV positive person is taking HIV antiretrovirals the risk of transmitting HIV to their uninfected partner can be reduced by as much as 96%. Some couples chose to conceive a child based on this projected reduction in risk.
PrEP – Another option for protecting the negative partner during conception is a short course of post-exposure prophylaxes (PrEP) during the time period while attempting to conceive. PrEP is when a person who is at high risk of contracting HIV is prescribed Truvada, an HIV antiretroviral medication in order to reduce the risk of infection.
Sperm Washing – In cases where the male partner is HIV positive and the female isn’t (or if both are positive and wish to avoid the risk of reinfection) sperm washing can be used. During the sperm washing process the seminal fluid is separated from the semen on the belief that most of the HIV genetic material is in the seminal fluid. The sperm is then inserted directly into the females womb during ovulation. Fertility drugs may be needed if pregnancy is not achieved through the insemination process alone. Sperm washing can cost as much as $1300-2000.
Reducing the risk to baby – Without intervention, 15 – 45% of babies born to HIV positive mothers would become HIV infected. The rate of mother to child transmission of HIV is decreased to under 2% when HIV antiretrovirals are given to both mother and child during pregnancy and delivery.