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atripla and sperms
May 2, 2009

Doctor I am taking a atripla as regimen today, my VL is undectectable, my cd4 are 205, I am 43 years old I am thinking have have baby with my sexual partner some day , she is a negative person, we was thinking have sex one time only with not protection for conception matters, does my baby will born negative or positive?

Response from Dr. McGowan

I am glad you are healthy and doing well.

Your question is a good one, and very complicated.

HIV cannot spread directly from you to your baby. In order for the baby to be infected the mother must be infected and then transmit the virus during pregnancy (most often at birth or through breastfeeding). So the main issue is to prevent HIV from being spread from you to your partner.

The first step is to maintain your viral load undetectable at all times. The lower the viral load, the lower the chance of spreading the virus, but that risk may still be present even though your viral load is undetectable. The reason for this is that some times even though the virus is undetectable in the blood (where we measure it), it may still be shedding (detectable) in the semen. This was recently shown in a number of studies. So some risk remains.

Some techniques such as "sperm washing" and timing of anti-HIV medication doses to the female partner around the time of sexual conact (PreP = preexposure prophylaxis) have been tried, but these need to be conducted under careful observation by experts in the field.

You should discuss this with your doctor/medical care provider and bring in your partner to have a open discussion about all the risks and benefits involved.

Best, Joe



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