HIV, hepatitis B and hepatitis C
If you or your partner is known to have HIV, hepatitis B or hepatitis C, you should receive specialist help and advice to conceive.
For a man who is HIV positive it is possible for you to conceive with an HIV‑negative woman through unprotected sexual intercourse under specific circumstances.
If you are taking HIV drugs known as HAART (highly active anti-retroviral therapy) the risk of infection during intercourse is minimal as long as all of these conditions are met:
You are taking your HIV drugs correctly.
Blood tests show that the virus has been undetected (called having an undetectable viral load) in your body for the past 6 months.
You have no other infections.
Unprotected sexual intercourse is limited to the time of the month when the woman is ovulating. Your doctors can help you determine the best days to try.
It is very important still to use protection during the times when you are not trying to conceive, to minimise the risk of passing on the infection.
If virus is detected in your blood, you are not taking your HIV drugs correctly, or you and your partner do not want to have unprotected sexual intercourse, you may instead be offered 'sperm washing'. This involves separating the sperm from the semen, which reduces the chance of transmission because HIV is carried by the semen. The sperm is then used for intrauterine insemination or IVF.
If you can meet all the conditions in the list above, sperm washing may not reduce the risk of HIV infection any further – it is never possible to guarantee that the sperm is completely free from the virus. Sperm washing may also reduce the likelihood of becoming pregnant compared with natural conception.
If you can meet all the conditions in the list above, NICE does not recommend also using 'pre‑exposure prophylaxis', in which an HIV‑negative woman takes antiretroviral drugs to reduce her risk of getting the virus before having unprotected intercourse with a man who is HIV positive. This is because it has not been found to reduce the risk of infection any further.
Before you make any decisions about trying to conceive you should be offered the chance to have a discussion with both a HIV specialist and a fertility specialist.
Hepatitis B is a virus which can infect and damage the liver. If one of you has hepatitis B, your partner should be offered hepatitis B vaccination because the illness can be passed on through unprotected sexual intercourse. For men with hepatitis B, you should not be offered sperm washing before having fertility treatment.
Hepatitis C is another type of hepatitis virus which also infects the liver. In couples where the man has hepatitis C and the woman does not, the risk of infecting your partner during unprotected sexual intercourse is thought to be low. However, you should have the opportunity to talk to both a fertility specialist and a hepatitis specialist before you make any decisions about trying to conceive. For men, this should include talking about treatment options to eliminate the virus from your body.