Wednesday, September 8, 2010

Unprotected Sex, Conception and HIV

Whether you agree that HIV positive people have the right to have children or not is a very personal and emotive issue. However, to be frank, it is irrelevant what you think. Because, human beings are exactly that, human. And so, knowing that you are HIV does not suddenly switch off your natural biological desires to have a family, bring children into the world and surround yourself with the warmth and love that can only be felt by a family.

First thing to understand is that this has been an extremely controversial area of HIV medicine for a long time and there are many differing opinions on what is safest and best. At the end of the day, the decision to conceive is intensely personal and should not be dictated by a health care provider.

Many health care providers and people will unhesitatingly tell you that you should not fall pregnant. Fertility experts will encourage you to invest thousands and thousands of rands in methods of Guaranteed Risk-Free, but Not Guaranteed Result methods of conception (like IVF or AI). There is nothing wrong with these methods. But with improved HIV drugs out there, HIV is becoming less of a 'fertility issue' (as in : how do we help this couple to fall pregnant when they have HIV and cannot have unprotected sex, thus an inability to fall pregnant) and is becoming a pure 'infection' issue (as in: here is a couple who are both fertile and can certainly fall pregnant through unprotected sex. How do we allow this natural event to happen without infecting one/both partners and baby?)

Second to understand is that there is a big difference between unprotected sex with ARVs and unprotected sex without ARVs. I will go into this more.

But first, what do you understand by the word 'safe'? If I say that it is safe for you to cross the road do you assume that I am providing a guarantee that you will not come to harm? In actual fact I am telling you that your risk is minimised and that you are most likely to cross the road without coming to harm. However, I cannot guarantee you that a speeding car will not fly through a red traffic light and hit you as you cross the road. Looking at the safety in terms of HIV transmission is similar.

We now know that a couple can conceive through the old-fashioned method of unprotected sex safely (i.e. with minimised risk, but not absent risk) if certain conditions are met.

Yes, let me say that again. A couple where one or both partners is infected CAN conceive through unprotected sex without harming eachother or the baby.

IF the following conditions are met;
  • Both/the HIV positive partner's viral load must be undetectable. This means that our laboratory test cannot reliably count any copies of the virus in the blood.
  • Neither partner is ill or suffering from a sexually transmitted infection at the time.
So, if this is something you are considering or want to know more about: ask your health provider questions, make sure that you are getting current, up to date answers and not being dismissed based on outdated knowledge. Be safe, be responsible and enjoy a normal life with the same expectations of having a family and raising children.

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