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long-term non-progressor wish to have child

Feb 2, 2013

I'm a long-term non-progressor hiv for 16 years, and I dont' take any medecine. My whife is hiv-negative. We never practiced unprotected intercourse. We wish to conceive a biological child. Can we do this safely through timed unprotected intercourse ?

Response from Dr. Young

Hi and thanks for posting.

The risk of HIV transmission from you to your wife is probably very low, assuming that you have a very low or undetectable HIV viral load. I'd hesitate to say that your risk is zero without additional information.

Having said this there are a few things that might be worth considering. First, the fewer times you have unprotected intercourse, the lower the risk. So, planning this around the times of her ovulation (and maximum fertility) makes sense. Second, we know that HIV medications can reduce the risk considerably. Indeed, this is why HIV medications are recommended by US treatment guidelines to prevent transmission. This could be accomplished by either starting you on treatment (perhaps for a brief period) or by offering your wife pre-exposure prophylaxis (PrEP). We've done the later in our clinic in this setting a few times over the years, and the strategy makes some intuitive sense. Lastly, though probably not indicated, you could also consider using the services of a reproductive medicine program- one that could offer up sperm washing as a way to most definitively reduce the risk of transmission.

I hope this helps, and wish you and your wife well. BY

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