Prospective parents with HIV may be anxious about what to expect in the process of becoming parents. Knowing what to expect will help ease any doubts!
Gay men make up the majority of people living with HIV in the United States. Drastic progress in HIV treatment over the last couple of decades has rendered it a chronic, manageable condition, in stark contrast to the early days when HIV significantly impacted the quality of life of those affected by it and was eventually terminal. Nowadays, people living with HIV can expect a normal lifespan, as highlighted by recent research (Conference on Retroviruses and Opportunistic Infections, 2020). Prospective parents with HIV can expect to be there for their children.
Leading a healthy lifestyle and adhering to antiretroviral therapy for the management of HIV are important factors in predicting future HIV-related health. New medications are easy to tolerate and have few, if any, side effects. New ways to administer HIV medications include soon-to-be-approved monthly or bi-monthly injectables, which will provide an extra tool for those who may not want to take pills every day. Injectables will make adherence to therapy easy, empowering more people to maintain their therapy in the long term and reap its benefits by becoming undetectable, i.e. eliminating all detectable virus from blood and fluids.
Being undetectable is highly desirable for people living with HIV, both because it provides health benefits to themselves, but also because undetectable people cannot transmit HIV to others, something that is known in the LGBT community as “undetectable=untransmissible” (“U=U”). Still, in the process of family planning there is an additional step which eliminates all possibility of HIV transmission, called “sperm washing”. Sperm washing separates the donor’s sperm cells from the seminal fluid, which harbors the virus. HIV infects blood cells – it does not infect sperm cells, which lack the receptors the virus needs. In addition to the washing step, the presence of virus (“viral load”) is measured in the semen before and after the washing step. Viral load measurements involve highly sensitive PCR tests capable of detecting miniscule amounts of virus. In this case, no virus would be expected prior to sperm washing, and especially after the procedure. Therefore, many steps are taken to ensure that the resulting sperm used for in vitro fertilization (IVF) is free of virus.
Antiretroviral medications are highly tolerated, especially compared to the early ones from the 80s/90s. While they no longer have side effects that affect quality of life, their long-term effects in various physiological processes and organs are still a matter of high interest in medical research, especially whether antiretrovirals affect the health and quality of sperm. The few studies conducted so far produced mixed results. Some showed antiretrovirals had a negative effect on certain sperm health parameters especially in older men when compared to people who do not take the medications. Potential parents should not be discouraged from exploring their reproductive options especially given the safety of using washed sperm for IVF.
In summary, people with HIV can expect to live a long, healthy life, providing a great opportunity to become parents! Antiretroviral therapy combined with sperm washing and PCR confirmation essentially eliminates the possibility of HIV transmission.
At Santa Monica Fertility, we can help you become a parent, regardless of your HIV status. We use cutting-edge science and a caring, compassionate approach to make the process as seamless as possible. If you are ready to get started with building your family, or just need someone to answer your questions, contact us or call us at (310) 566 1470.