World AIDS Day 2017: How to conceive a baby if both partners are HIV positive?

Dr Gauri Gore tells us how two HIV positive partners can plan for a healthy and HIV negative baby

This question might seem a little illogical to many, but there are HIV positive couples in this world who are yearning to have a baby. Of course, if you are living with an HIV virus, the possibility of getting AIDS eventually is always looming. Obviously, they will not want to pass on the virus to your baby. And these couples might want to have a baby like any other regular couples. We spoke to Dr Gauri Gore, consultant gynaecologist, Zen Hospital, Mumbai to know how two people suffering from HIV can have a baby. Here is an excerpt from the interview:

If two partners are HIV positive can they have an HIV negative or healthy child through natural conception?

If two partners are HIV positive we presume that they are on antiretroviral therapy (ART) that is used to treat the virus. These medications don t kill the virus but make their progression slow and prevents the growth of the virus. This delays the process of the HIV virus turning into a full-blown AIDS. However, both partners need to be counselled about the consequences. There are chances that they can conceive naturally and usually, the fetus will not get the virus during conception. But then there are chances of the virus being transmitted from the mother to the child through the placenta during pregnancy. Being on ART can reduce the risk but there are no ways in which we can be 100 percent sure that the virus will not be transmitted to the baby. It also depends on the viral load of the parents. If both parents have a low viral load they can try natural conception after a thorough consultation and take advice from a gynaecologist and medical officers in ART centres.

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But is it advisable to go for natural conception and have unprotected sex if you are HIV positive?

Ideally, people who are HIV positive should always practice safe sex. The reason being, if the viral load of one partner is higher then there is a chance of passing on a potent drug-resistant viral trail to the other. So if two HIV positive people plan to have a baby and conceive naturally they need to be sure that their viral load is low, which can be done by proper testing and counselling at ART centres.

Even if the viral load of the partners is low how can the baby be protected from getting the infection?

For an HIV-infected woman antiretroviral therapy (ART) should start before pregnancy, both for her own health and to reduce the risk of HIV transmission during pregnancy. The goal is to lower the mother's HIV viral load as much as possible to prevent infection of the fetus. After delivery, the infant should receive ART for six weeks. In addition, the mother should avoid breastfeeding her baby to prevent transmitting the virus through her breast milk.

Are there other ways of conceiving a baby for HIV positive partners which are safe?

If they are counselled not to have penetrative intercourse to conceive a baby then they can take help of IVF procedures or sperm washing. In sperm washing, the HIV virus is removed from the sperm and it is inserted in the woman s womb through artificial insemination.

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