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Getting Pregnant By Sex with HIV
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"Benefit of antiretroviral therapy for serodiscordant couples willing to be parents"
Pablo Barreiro, Vincent Soriano, Marina Nuñez, Juan Gonzalez-Lahoz. Infectious Diseases, Hospital Carlos III, Madrid, Spain
HIV+ persons who wish to be parents with a HIV-neg partner may pose at risk of infection the couple and eventually the newborn. To minimize this risk, in vitro fertilization is often advised in such cases. However, this is an expensive procedure. Furthermore, social and personal believes often discourage some couples from in vitro strategies. Given that HIV infectivity (both sexually and vertically) is clearly associated with the risk of transmission, some HIV+ persons with undetectable viral load have pursuit pregnancies with his/her HIV-neg partner by natural sexual relationships.
We retrospectively recorded information from all HIV-serodiscordant couples followed at our institution who had had newborns during the last 5 years, without using in vitro techniques. Before initiation of sexual relationships in an attempt to look for pregnancy, they had been adequately informed about the risks of HIV transmission, and were advised to reduce intercourses exclusively to the fertility days. Moreover, exams to exclude infertility in both partners were performed in advance. HAART was provided (if not already in use) and sexual relationships were initiated after >6 months with <50 HIV-RNA copies/ml. All HIV+ women who became pregnant followed rules for preventing perinatal HIV transmission.
75 children were born from 74 HIV-serodiscordant couples. The HIV+ case was the male in 52 cases and the woman in 22 cases. No cases of HIV sexual nor vertical transmission of HIV were recorded.
Sexual relationships during the fertility days may be considered an alternative to in vitro fertilization in HIV-serodiscordant couples willing to be parents. The achievement of undetectable viral load with HAART in the HIV+ partner is a necessary condition to avoid HIV transmission in this setting.
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