Concerns about getting pregnant...

[Maya]

Hi All...

Forgive me if this isn't the right spot to post my question. I wasn't sure where to post, but have some important questions. Admins, please feel free to move this to a more appropriate spot, if there is one.

I am fairly naive about HIV, but I have learned a lot by reading through all of the posts here. So, thanks to all who post.

I am HIV negative, female, 38 and single. My biological clock is ticking and I am considering having a child with my best friend, a 40 year old gay male who is VERY sexually active. He did the mouth swab test two weeks ago and it seems that he is HIV negative as well.

A little info on my friend. He is a physician who is meticulous about his health in general--but especially his sexual health. I know him very well and I trust him. He says that he never engages in unprotected sex and I believe him when he says that. Nonetheless, by his own admission, he has been with at least 100 men over the last year or so. These are mostly random hookups with men he meets on some of the popular apps/sites or in the locker room at the gym. Normally, he and these guys perform oral sex on each other. He is happy to ejaculate in a guys mouth if he will let him (of course!), but he never lets these random guys ejaculate in his mouth. Sometimes, though, he connects with certain guys on a deeper level and ends up dating them--and these guys he has protected anal sex with (he both tops and bottoms). With over 100 hook-ups over the last year, I am sure that he has been with men who are HIV positive.

In addition, before going on this year-long rampage, my friend was in a four year relationship with another man who was HIV positive. They were careful and safe, but this guy was still HIV positive--and this concerns me, even though their relationship ended two years ago and my friend is still negative.

Anyway, we have spoken to a doctor who would basically artificially inseminate me (IUI). Because I have identified my friend as a live donor and co-parent (as opposed to anonymous donor), there is no testing of his semen for HIV, like there is when a man donates to a sperm bank. In fact, they won't even test his semen for HIV at the stage of the sperm washing. So, basically, we are completely on our own in making sure that he is completely healthy before doing this.

We made the definitive choice to move forward with our plans to have a child last month and, since then, he has not touched a man. I didn't ask him to do this, though I would have. He just knows that he is potentially putting both me and our eventual baby at risk when he puts himself at risk. He has also said that he wants to calm down on the random sex and reprioritize, now that he may be bringing a child into the world. He's excited about all of this and I am proud of him for the decisions that he is making on his own.

All that said, I am still concerned about his previous exposure to HIV. He has agreed to abstain from all sexual contact until we conceive. The last time he had sex, which was protected, was in mid-June.

As I said, he is HIV negative, but given his sexual history, I feel like we should give it some time (with him abstaining) and have him test again to make sure that he really is negative.

But then, we went to the doctor the other day and they suggested that we start trying right away because of my age (they don't know my concerns).

Could anyone kindly offer me some informed advice?

My questions/concerns are:

1. Since we're both negative--am I overreacting by not wanting to conceive right away?
2. If you feel I'm not overreacting, how long should we wait to have him test again?
3. How long should we wait to conceive or can we just start trying now?
4. How reliable is the swab test he recently did?
5. How long can HIV lay dormant before showing up? (I'm concerned both about his recent hookups, as well as his long-term relationship with the guy who was, without a doubt, HIV positive).
6. If he abstains, are we safe to conceive or can HIV show up long down the line?

Many, many thanks!

[RapidRod]

He needs to have tested 3 months negative after his last unprotected sex.

[Ann]

Maya,

You BOTH need to have tested hiv negative at three months past either of your last incident of UNPROTECTED anal or vaginal intercourse. Your friend says he hasn't had unprotected anal intercourse (at least for some years) - and oral isn't a risk.

It makes no difference that he had a long-term relationship with someone who was hiv positive. For a start, they used condoms, and he has also tested hiv negative far beyond the window period that would have existed for their relationship. There are thousands - even millions - of serodiscordant relationships where the negative partner remains negative through the simple use of condoms for intercourse.

In fact, there have been three long-term studies of couples where one is positive and one is negative. In the couples who used condoms for anal or vaginal intercourse, but no barrier for oral activities, not one of the negative partners became infected with hiv. Not one. One of these studies went on for ten years and all told, the three studies involved hundreds of couples; gay and straight, on meds and treatment naive. All bases were covered.

The bottom line, from where I sit, is this: Do you trust this man or not? Have you known him long enough to trust his integrity? If the answer is NO, then maybe you should go the sperm bank route where the semen is tested for hiv. If you do trust him but have that little niggly doubt, go with him and get a rapid test done together so you can see his result - and also know for sure your own status. Confirmation never hurts.

From what you've told us, I'd say go for it - but I'm not you and ultimately, you have to make this decision for yourself. It all comes down to how well you know him and how much you trust him when he says he hasn't been having unprotected anal or vaginal intercourse (the only true sexual risks for hiv infection). Whatever you decide, good luck with the baby making.

Ann

[Maya]

Thank you Rod and Ann.

And Ann...fabulous, insightful answer. I do trust him. I hope I'm not being naive.

[Ann]

Maya,

You're welcome, and good luck with the baby-making.

Ann