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Conceive Naturally with PreP?

Apr 15, 2017

Hello, My husband and I have been thinking about conceiving naturally. He was diagnosed with HIV about a year ago and has been on medication since. However, he has not achieved undetectable status. His viral load has been around 200 for the past few lab tests. If I use PreP, would you say it'll be safe for us to try to conceive now even though he has a detectable viral load, or would you recommend us waiting until he becomes undetectable for 6 months? Thank you very much.

Response from Mr. Jacobs

HI there, Congrats on the decision you and your husband have made.

Fortunately, PrEP has been found to be safe for naturally conceiving children with an HIV positive partner (http://www.aidsmap.com/PrEP-appears-safe-for-use-in-conception-but-may-not-be-necessary-if-partner-is-taking-treatment/page/2692408/). What is key here is for you to adhere very closely to the regimen, using Truvada daily for HIV prevention, and waiting 20 days for it to build up in vaginal tissues. With daily use, there is no reason to believe you would be at risk for contracting HIV with a partner with a detectable viral load.

The other piece of good news here is that having a viral load of 200 copies still essentially renders your husband close to undetectable. In the "Partners" Trial, which conclusively demonstrated that people who are undetectable for six months or longer cannot transmit HIV to others, used 200 copies as the cut off level to measure detectability. In other words, no one with a viral load of 200 or lower, transmitted HIV in this or any other trial (http://www.aidsmap.com/More-confidence-on-zero-risk-still-no-transmissions-seen-from-people-with-an-undetectable-viral-load-in-PARTNER-study/page/3072326/).

Many women have generously shared their journey with us of conceiving children on PrEP. Here are some of their personal stories: http://www.thebody.com/content/78763/pregnant-thanks-to-prep.html; https://www.hiveonline.org/prep-helped-us-conceive-our-first-child/ .

You can also read more about PrEP and conception in the international Facebook Group, "PrEP Facts: Rethinking HIV Prevention and Sex" : https://www.facebook.com/groups/PrEPFacts/ .

I do hope this information helps you and your husband to make the healthiest and most loving choice possible. Thank you again for writing in!



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