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thoughts and opinions on PrEP for getting preg?
Sep 13, 2012

Hi,

You may remember me, I've posted here before? Negative single lesbian wants to be a mom, has gay poz (UD for several years, on Stribild since it was called Quad, neg for other STDs, been wearing boxers!!) super-uncle donor. We were about to go sperm washing route but for many many reasons decided to ask my doc, who's an HIV specialist (at a reputable practice in a major US city!) despite my being negative, if he'd consider prescribing me PrEP for when I try to conceive in an at-home insemination (no sex, just turkey basting, lol). He did it!

His recommendation was to start taking Truvada at about day 7 of my cycle and to continue until 2-3 days after the last time I inseminate. Wanted to hear your thoughts on this as a treatment advocate? Of course my donor would be STD tested again right before I use his sperm. Nelson's still on the baby name list, lol!

Response from Mr. Vergel

You put me on the spot.

I will give you my personal opinion, and that is all it is.

In the UK National Institute for Health and Clinical Excellence (NICE) reported that they do not think it is necessary to go through sperm washing if the sperm donor has had HIV indetectable viral load for a long time: Sperm Washing Fertility Treatment Not Necessary: U.K. HIV Draft Guidelines

NICE do not even mention using Truvada as a preventative measure. I think it is good that you will be using Truvada to prevent getting infected, and you will have an additional "firewall" with the fact he has undetectable viral load. A recent study showed that there was detectable HIV in semen of 30% of men with undetectable viral load in the blood.

Is it 100% risk free? Nothing in life is.

I would do it...but I do not want to be liable for having said this, so I repeat that this is my personal opinion about what I would do and in no way I am suggesting or recommending you to do this.

I hope your last name is not Mandela or Rockafeller. They will think your son is a hero or a super rich person.

Good luck and please let us know. This is actually a story we would love to feature (without your names if you wish) at thebody.com when all is said and done. I would not be surprised if a few couples are doing this already.

Nelson

Reference:

"Eighty-three of the 101 MSM had undetectable levels of HIV in their blood samples. Though most also had undetectable HIV in their semen samples, 21 (25 percent) had detectable seminal viral loads.

Politch and his team note, however, that HIV levelsfree-floating HIV-RNA and both HIV-RNA and HIV-DNA in cellswere significantly higher among those with detectable blood-based viral loads, compared with those with undetectable blood-based viral loads. For example, whereas the average free-floating viral load was 4,438 copies among those with detectable blood-based HIV levels, it was 51 copies among those with undetectable blood-based HIV levels.

Whether or not the free-floating virus detected in the semen samples of those with undetectable blood-based viral loads is of high enough quantity and/or quality to establish infection in a sexual partner wasn't explored by the researchers.

The authors did note, however, that the prevalence of HIV shedding among those with undetectable blood-based viral loads documented in this study proved higher than has been reported in other studies. "This is likely due to the high prevalence of STIs and genital inflammation in our sexually active MSM cohort." Undetectable Viral Load? Not Necessarily in Semen



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