How does one manage to have children and not transmit HIV? In general, the way to prevent transmission is to avoid unprotected sex, but to have children you typically need to be having unprotected sex.
Am I missing something here?
Either in-vitro fecundation (though I'm not 100% sure if that'd work that well), or else the fact that he is treated makes for very low transmission rate, even when having unprotected sex, enough that it seems to be reasonable to try and have kids that way.
Yay for the third world actually knowing about this stuff.
It is entirely possible for HIV infected mothers to give birth to uninfected babies. The placental barrier that keeps the mothers immune system from killing the parasite that is the baby is also the same thing that prevents the baby from becoming infected while during development. If the mother is on anti-retroviral medication the chance of transmission becomes incredibly small. The primary danger period is in the last few weeks before birth and during birth where the baby can become infected.
There has been a massive call for state hospitals to provide anti-retroviral medicine for pregnant mothers to reduce mother to child transmission all over the third world. It is a big topic although it does not deal with all the issues like how the treatment is only for pregnant mothers during pregnancy which results in a large number of orphans, as well as the fact that the baby can become infected from drinking their mothers breast milk. This is also why in the third world breast milk donations are first in such short supply and secondly desperately needed.
The actual transmission rate for HIV is statistically low compared to other sexually transmitted diseases. The type of sexual act influences the chance of transmission with the recipient of penis in anus and penis in vagina being the highest. Both of these rates are lower than 50% per encounter, but I believe penis in anus is about 30% so still kind of high. Being male dramatically reduces your chance of contracting HIV with Penis in vagina probably only being as high as about 10% at most.
However, like all statistics, relying on them is like playing Russian roulette. Play enough and you will loose, and some poor souls loose on the first try. Which is why protection is important. Lastly, for those who are HIV infected, having unprotected sex with other HIV infected people is dangerous. Common sense would have you think that once you are infected there is nothing more that the virus can do to you, but you can get infected again with another mutation of the virus, making treatment less effective and increasing the rate at which the virus kills you.
Lastly. Anti-retroviral medicines basically kill off all the virus actively in your bloodstream. It is pretty close to a cure in many ways, unfortunately the virus infects the bone marrow where new cells are produced and where the anti-retroiral medicine cannot touch it. This results in viral resevours that can "re-infect" the person at any time. This is also why that one guy in Europe who had a rare form of leukemia was able to receive a bone marrow transplant that cured him of HIV. It can be done, but it currently requires rare circumstances and a huge amount of effort and cost.
I hope that was informative.
