HIV positive husband wants to have unprotected sex

Question

I am married to an HIV+ man. We have been having unprotected sex before I discovered that he is HIV+. After the discovering, we both went for HIV test and my result came out HIV-. It was explained to me that he didn't transmit the virus to me because his viral load is low. Since then we have been using condom. Recently, my husband has been pressing me to stop using condom with him because he wants to make babies. I am scared about not using condom with him because I was so LUCKY not to have contacted the virus before my discovery. His claim is that since his viral load is low and he didn't transmit the virus to me after all the years we have been together, then we can continue having sex without using condom. PLEASE doctor, should I believe him and go ahead with his proposal (having unprotected sex so that we can make babies). PLEASE I desperately need your advise bacause the issue is seriously affecting my marriage now.

Answer

Hello,

I would very strongly advise you not to have unprotected sex with your HIV-positive husband. His belief that he cannot transmit HIV to you because his viral load is low is wrong dead wrong! Make an appointment immediately for you and your husband to discuss this situation openly with his HIV specialist. The HIV specialist will confirm my statements and clear up your husband's misconceptions. (If he/she doesn't, it's time to find a new HIV specialist.) It is true that having a non-detectable or low viral load decreases the chances of HIV transmission, but it absolutely does not eliminate the risk. It's also worth noting that the HIV viral load in the semen may be different than the HIV viral load in the blood.

It is possible to still have children, but there is some risk involved. The technique involves sperm washing and in vitro fertilization. You can check the archives on this site for further details. You'll need to locate an OB/GYN doctor who is familiar with the procedures necessary for HIV serodiscordant couples to conceive while minimizing the risk of viral transmission. Your husband's HIV doctor should be able to refer you to an appropriate specialist.

Good luck.

Dr. Bob