Hello, I'm 30yrs old,6yrs HIV+ & not on meds. My partner is also poz & on meds. Two mths ago my CD4 count was 668 and I'm so desperate to have a baby. My partner and I have looked at the only medical procedure we seem to have available in our area (In South Africa) which is artificial insemination. Is it a good option? Would it be safe to try to have unprotected sex even just for a few days in the hope of conceiving?

Your question raises a couple of issues. Both unprotected sex and artificial insemination would both carry the potential risk of superinfection (i.e., passing HIV from one infected person to another). Superinfection has been documented, but it is unclear as to how often it occurs. If your partner has suppressed viral replication on medication, the risk of transmission from him to you is much lower (and his risk of acquiring superinfection from you is also lower).

If you are asymptomatic with a CD4 count of 668, antiretroviral therapy would not necessarily be recommended. However, if you are thinking about getting pregnant, you might consider starting an antiretroviral therapy regimen to minimize the risk of superinfection from your partner and to minimize the risk of passing the virus to your baby. The US Guidelines for the Use of Antiretroviral Agents During Pregnancy are available on this web site and the WHO guidelines are available at http://www.who.int/reproductive-health/stis/mtct/index.htm. Each of these web sites/documents has extensive information on mother-to-child HIV transmission and how to prevent it. I would urge you to review this information and then discuss your options with your care provider.