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Reducing the Risks of Conception: Getting Pregnant When One or Both Partners Is HIV+

By Rebecca Denison

August 20, 2004

If you have decided to have a child, there are strategies for getting pregnant that reduce the risks to the mother, the father and the baby.

The chances of getting pregnant will go up and the risk of an uninfected partner getting HIV will go down if you only attempt to conceive when you are fertile. You can tell when a woman is fertile if:

Another way for a woman to tell when she's fertile is by tracking her temperature on a chart. Here's how:

A man can improve his fertility by not soaking in a hot bath or a hot tub; not using alcohol, marijuana and other drugs; not wearing tight pants.

You can lower the risk of transmitting HIV to the baby or an uninfected partner by reducing your viral load (or your partner's), before trying to get pregnant. Having an undetectable viral load does not eliminate the risk, but it does reduce it.

Once viral load is undetectable and the woman is in a fertile period of her cycle, there are a number of ways to try to get pregnant:

If the woman is HIV+, but the man is not:

Zero risk

Very low risk

Medium risk

Most risk

If the man is HIV+ but the woman is not:

There is currently no "zero risk" method for a couple in this situation to conceive. Such couples are often encouraged to look into adoption, foster parenting or using artificial insemination with semen from an uninfected (tested) donor.

To reduce, but not eliminate, the risk of a man infecting a woman during conception:

A process called sperm washing can also reduce the risk, as can having sperm evaluated for evidence of virus. Unfortunately, there are very few places in the U.S. that do this. Two resources are:

If both partners are HIV+:

If you are both HIV+ and have unprotected sex, there is a possibility that one of you may pass on a worse or drug-resistant strain of HIV to the other. This is called "reinfection." To reduce this theoretical risk:

Go to your doctor for "preconception" health care and counseling before you start trying to have a baby. Your doctor can make referrals to specialists and advise you on medical conditions or other issues that may affect your pregnancy.

A more detailed version of this article appears in the March 2002 issue of WORLD (Women Organized to Respond to Life-Threatening Diseases) magazine. Visit WORLD's website at:

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