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Mixed status couple and family planning.
Sep 7, 2010

HI DOC - I am a HIV poz male and my fiance is neg. What are your thoughts on being "undetectable" and my fiance being on antiviral meds while trying to conceive? How high or low is the risk of her or the baby contracting the virus? If I was your patient what advice would you give? We have done a lot of research about our options, but are currently wondering about this method. Thanks for your time and expertise. Jaime M New Britain, CT

Response from Dr. Henry

There are low tech (cheaper) and higher tech (expensive) approaches to safely concieve in the case of discordant couples. For the + person having undetectable HIV levels and for both having no active sexually transmitted disease (esp with ulcers and herpes simplex). Sperm washing is not easily available in US unfortunately but can provide some additional reasurrance. Minimizing true unsafe contacts by only having unprotected sex when female is ovulating and possible judicious use of pre or post exposure prophylaxis are also useful approaches in certain settings. There is no one best approach but the good news is that in a high percentage of cases a safe pregnancy can be achieved (often there is a separate concern of fertility issues which may need to be addressed). KH



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