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Positive but I want a baby:

If either of you has HIV the reality is that you should never have sex without a condom. But the truth is that many HIV-infected women and men want to have children.  There are methods that reduce the risk of HIV transmission.

One of these is sperm washing. Or there is a risk- free option where you can have artificial insemination. But these are expensive and out of reach of most South Africans.

So how do you plan a pregnancy if you cannot afford these?

* If the woman is positive and the man negative you can use vaginal artificial self-insemination. This is the process of placing sperm into your vagina without your partner’s penis going inside you. This gives you the chance to get pregnant without the risk of passing HIV on to your partner.

* Do not attempt to fall pregnant if either of you (or both of you) have HIV without working very closely with your clinic.

*In order to have unprotected sex you both need an undetectable viral load before doing so. This would imply you take ARV medication for at least 3 - 4 and up to 6 months prior to sexual intercourse.

* You need to have regular tests to check your viral load and cannot have unprotected sex until it is ‘undetectable’.

*You need to carefully time the intercourse so it is on your fertile days. This reduces the times you need to have unprotected sex and exposure to the virus.

* The negative partner should be ready to start a course of post-exposure prophylaxis PEP (ARV drugs taken after exposure that can prevent transmission).

(Source The Southern African Journal of HIV)

If you have unprotected intercourse there is always a risk the uninfected partner can contract HIV. There is no way to totally prevent the risk. This is a high-risk choice and you should never proceed without six months of testing and treatment and close consultation with your clinic. 

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