Your Guide to HIV, AIDS and Fertility

As part of World AIDS Day, The Ribbon Box would like to raise awareness of the impact HIV and AIDS have on fertility.

Advances in drug therapies for HIV mean that people can become parents through natural conception without passing on the virus, but these are more accessible in various parts of the world than others.

What is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the immune system. If left untreated, eventually, the person’s immune system will completely deteriorate.

What is AIDS?

AIDS (acquired immune deficiency syndrome) describes a series of illnesses and infections that impact an HIV-positive person at the last stage of the HIV infection when the immune system is critically damaged. Not everyone with HIV will develop AIDS but without treatment, AIDS is the final stage of HIV.

According to the UK HIV and AIDS charity Action Aid, “women and girls are disproportionately vulnerable to HIV” due to “deep-rooted gender inequality”, particularly in sub-Saharan Africa. Click here to support Action Aid.

The WHO identifies five key reasons:

1. The power imbalance resulting from domestic violence leaves women and girls less able to negotiate condom use to protect themselves from HIV infection.
2. Fear of being shamed for being HIV positive or domestic violence because of women and girls’ HIV status limits their access to life-changing services such as antiretroviral treatment (ART), preventing mother-to-child HIV transmission as well as psychosocial support.
3. The increased prevalence of HIV in older men leaves young girls more vulnerable to the infection when subjected to child marriage. This imbalance of power also means young girls are less likely to successfully negotiate condom use or seek out essential services.
4. Sexual violence results in a greater risk of HIV transmission when physical trauma and vaginal lacerations and abrasions are inflicted by sexual force.
5. Women experiencing domestic violence are reported to be more likely of having multiple sexual partners, putting them at greater risk of acquiring HIV.

How does HIV and AIDS affect fertility?

Biologically

Neither HIV nor AIDS causes infertility. You can still have a baby if you or your partner is HIV positive. However, HIV infection can interfere with the reproductive system so assistance in family-building efforts may be required.

Socially

Studies in sub-Saharan Africa (where HIV and AIDS are particularly prevalent) have shown HIV and AIDS impact fertility indirectly; as a result of changed behaviours.

Fewer children or more children?

Improvements in AIDS education have meant the use of condoms is becoming more commonplace, the age of first sexual relations is increasing and a reduction in premarital sexual encounters.

Some couples may decide to have fewer children to avoid leaving many children behind after an early death, whilst others may intend to have more offspring to improve the chances of survival.

Sperm and mother-to-child transmission

If the man using his sperm for conception is a carrier of HIV, the fertility clinic will wash his semen sample to remove possible virus particles.

If a woman carrying the baby through pregnancy, delivery and then breastfeeding is HIV-positive there is a risk of vertical transmission, and though the risk is low (<2%), measures should be put in place to prevent transmission. Women with HIV are also more at risk of complications during pregnancy and birth so additional care should be taken.

The guidelines on providing fertility treatment for people with HIV vary across the world but our trusted partners are available to speak with should you have any concerns.

You can see our partner fertility clinics here.