Many HIV-positive Australians have chosen to have children. Due to increased knowledge of HIV and advances in HIV treatments there are a range of strategies that can be used to minimise risk of HIV transmission to a partner or child.
There are a number of options that substantially reduce the risk of HIV being passed from an HIV-positive man to his female partner or to a child during its conception. These include:
- the male partner being on effective antiretroviral treatment for an extended period to achieve an undetectable viral load (while also free of STIs).
- the female partner taking antiretroviral treatment (PrEP) to prevent HIV infection.
- having unprotected sex only while the woman is ovulating to reduce the number of times unprotected sex occurs.
- sperm washing, which requires the male partner giving a semen sample to a clinic. The sperm (which does not contain HIV) is then separated from the seminal fluid (which does contain HIV) before the sperm is injected into the woman’s uterus. Sperm washing is expensive as it requires the involvement of a fertility clinic.
HIV-positive gay men wanting to have children face additional barriers related to access to reproductive services. Reproductive services, surrogacy and adoption are covered by state and territory legislation so the law varies across jurisdictions.
For gay men who are considering becoming (or already are) parents, Gay Dads Australia offers specific support, information and advice.
The risk of passing on HIV from mother to child is very low (less than 1%) if the mother is on successful treatment, the child is born through caesarean section and the baby is not breastfed.
Options to reduce risk of transmission from an HIV-positive woman to her HIV-negative male partner while trying to conceive include:
- the male partner taking antiretroviral treatment (PrEP) to prevent HIV infection.
- self-insemination rather than unprotected sex. Using this process, the male partner ejaculates into a container and the sperm is then inserted into the vagina using a syringe.
If you are thinking about having a child, it is important to make sure you and your partner understand all your options and you have an expert medical team to support you. Talk to your doctor as soon as possible as they will understand the specifics of your circumstances and have access to the latest information about reducing your HIV transmission risk.
For further general information see:
- AFAO’s Having Children
- Pozhet’s Having a Baby
- Living Well: Women with HIV – Having Children