We are a couple which is positive woman and negative man.We want a baby.Now my wifes viral load is undetectable and CD4 count is about 800.She uses only combivir now.What is your suggestions. Regards,

Although your wife has an undetectale viral load in her blood, this does not mean that the HIV in her vaginal secretions is undetectable. Also, undetectable does not mean zero. So, the fact remains that you could get HIV from your wife.

I would suggest artificial insemination. Other options are adoption or a surrogate mother. All these options can be expensive and I have heard of many successes trying to do "artificial insemination" on your own. Some people refer to this as the turkey baster method. There are test kits that one can buy at the drug store that help determine when your wife is ovulating if you can afford them. Many women "know" when they ovulate as it is generally around days 12-14 of a 28 day cycle and associated with a change in the cervical mucous. You can ejaculate in a container and immediately draw up the semen in a baster or syringe and immediately insert it in your wife's vagina and squirt the semen inside towards the cervix. You should talk to your wife's doctor about this.

My other concern is that she is on combivir alone which although may work in the shortterm, it is usually not that durable (meaning long lasting). The chance of having viral breakthrough is higher than on a stronger combination. I do not know where you live and you may live in a country with limited drugs but if you live in a country where non-nucleosides and protease inhibitors are available, I suggest you talk with your wife and her doctor about a more potent combination.