There are three ways to transmit HIV: blood transfusion, sexual transmission, and mother-to-child transmission. Male to female transmission is easier, often through semen. If the viral load of a man is greater than 1000, the virus can be transmitted to a woman through semen secretions, after which the infected woman then transmits it to her fetus. Pregnant women have a 20-45% chance of transmitting the disease to their children, and the delivery process and breastfeeding can also cause infection.
If the male partner is positive, regardless of whether the CD4 level is very high, such as greater than 500, greater than 800, as long as there is a viral load must take medication. After six months of medication, 95% to 98% of patients will have undetectable viral load. According to statistics, the transmission rate between couples in this case can be reduced by 96%, and basically there is no contagiousness, and the process of fertilization can be completed safely.
If a man has no detectable viral load, he is basically not contagious and can become pregnant through normal sexual intercourse. There are also some methods of fertilization introduced on the Internet, such as sticking holes in the front of the condom so that there is less contact, which reduces the damage to the vaginal mucosa and lowers the chance of infection; there are also methods where the semen is sucked up with a syringe or an artificial conception aid after masturbation and pushed deep into the vagina for conception. These are purchased by patients themselves from adult stores and can be tried, but are not fully promoted.
In the United States, there have been no abnormal maternal deliveries in male HIV-positive families for nearly a decade, and 100 percent of the children are healthy, and our hospital can achieve 100 percent. However, the possibility of infection cannot be ruled out, in which case the woman should take some antiviral drugs for blockade.
The earlier you take it, the better. It is the same as prevention after occupational exposure. If the viral load is not detected in the male, it depends on the will of the female partner to take the medication. Since the medication has certain side effects, the female will also have to do relevant blood tests, liver and kidney function tests. I have contacted more than 100 cases of male positive and female negative maternal delivery, there is not a single case of women being infected, only half of the women took the blocking drug, the other half did not, and there are about 10%-20% of women who took the blocking drug did not take the whole thing, so it can be said that it is very safe.
How often should I be tested after sex?
Before having sex and during pregnancy, women should do various basic tests, including the four immunizations, hepatitis B, hepatitis C, syphilis, and HIV; after sex, they should be checked for infection at 1 month, 3 months, and 6 months, respectively, and if they are pregnant, they should be checked at 3 months of pregnancy and rechecked again at 6 months. If the woman confirms that there is no infection, the child will be born without being tested and will definitely be healthy.
If the man is HIV-positive only after pregnancy, should the woman be tested first or should she take the medication immediately?
If the male partner is positive only after pregnancy, you can observe first, it is possible that the pregnant woman is not infected. Generally speaking, you can wait for three months before checking, or you can check more closely, once a month. If the test is positive then do mother-to-child interruption.
It should be added that the HIV screening rate for pregnant women can reach 98% in our country, and it is a mandatory free pregnancy test program. If the husband is found to be HIV positive only in the fifth or sixth month of pregnancy and has not had sex during that time, the pregnant woman has already been tested once in the third month and is negative, so the disease can be ruled out.
Can I be safely fertilized through assisted reproductive technology?
Since the virus mainly exists in semen secretions, in foreign countries, such as the United States, Japan and Thailand, sperm washing can be done to wash the sperm and then conceive through assisted reproductive technology, which can avoid the transmission to the greatest extent. However, this method has not yet been carried out in China, and if done abroad it will cost a lot of money and time, for example, it costs about 300,000 to do it in Thailand, and also requires four or five round trips, so it is difficult to say that it will be successful in one go.
It is important to emphasize that China’s infectious disease law prohibits hospitals from accepting AIDS patients for assisted reproduction, including artificial insemination and IVF.