Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date. I was wondering what are the chances of infection if someone has been on medication for approximately 8 years and there is no viral load detected and he/she wants to get pregnant or impregnate someone?
Lisa Capaldini, M.D.
Internal Medicine
You're asking a question that is a wonderful sign of the times: now that, with appropriate medical monitoring and/or medications, people with HIV can shoot for a normal life expectancy, what about their having kids??
Here's what we know: if the Mom is HIV positive, and she has a viral load less than l,000 at 36 weeks gestation, she has about a 1% chance of having an HIV-infected baby. Or, looked at another way, women who get effective anti-HIV therapy, IF they are able to take their meds and they work, have about a 99% chance of bearing an HIV-negative infant.
On the Dad's side (assuming the father is HIV-positive) the data isn't as clear but it is promising. If the Dad's blood viral load is undetectable, the semen viral load is likely to be very low, too. With "semen washing," HIV-carrying cells may also be eliminated from semen. Data from Boston semen-washing centers is promising: so far, there have been NO HIV transmissions from Dad to Mom, or from Dad-to-Mom-to-baby! For people who don't have access to studies like this, the data looks like this: IF your blood viral load is undetectable, your semen viral load is likely to be low, too. How likely (1 in 1,000, 1 in 500, 1 in 50,000) HIV infection from Dad to Mom in this setting is not known. The ideal option is to be part of a study where this risk is reduced to the lowest possible.
Good luck!!
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