Hello, I'm 37 years old women I'm hiv positive and my husband is negative and we want to have a baby, we have been using safe sex ever since found out and now we are not what some of the ways for him to get me pregnant, and of course protecting the fetus once I'm pregnant, I understand there is new drug to protect the baby form the disease, now my question is HOW DO I GET PREGNANT WITHOUT RISKING OF INFECTING MY HUSBAND....

If you are considering pregnancy, it is important for you to disucss this with your care providers so that you can make plans to optimize your health and minimize the risk of transmitting the virus to your husband and your baby. You don't mention whether or not you are on therapy and what your viral load is. To optimize maternal health and minimize the risk of transmitting the virus to your baby, most experts would recommend antiretroviral therapy. There are many different drug combinations that can be used; recommendations for a specific woman depend on treatment history, present viral load, resistance testing, etc. The "Guidelines for the Use of Antiretroviral Therapy During Pregnancy", available on this web site, have a lot of information on preventing mother-to-child transmission. A recent case report in the New England Journal of Medicine (Riley and Yawetz, "A 34-year of HIV positive woman who desired to become pregnant", NEJM, 353:1725, 2005; the New England Journal is available through many public libraries) also has a very nice discussion of a case similar to yours.

Another major issue is preventing the transmission of HIV to your husband. While antiretroviral therapy will reduce the risk of transmission, there still is a risk that you may pass the virus with unprotected sex. Artifical insemination may help to protect your husband from this risk. After reading the abovementioned materials, I would urge you to discuss your options with your HIV and OB-GYN care providers. Please also feel free to write back if you have further questions.