Condomless Sex as a Pathway to Parenthood for People Living with HIV

HIV Parenting Choices

Advancements in HIV treatment, increased access to healthcare, and changing attitudes have contributed to many positive changes for positive people. This includes those of us who wish to become parents. A key development in the journey towards positive parenting was the wide acceptance that sex without a condom (aka – the old-fashioned way) can be a safe option for conception—with the right science and proper planning. In this blog, we’ll explore how condomless sex can support your journey to parenthood, focusing on key concepts like the Undetectable = Untransmittable (U=U) principle, the role of PrEP, and essential tips for planning and communication.

The Power of U=U in Safe, Condomless Sex - What is U=U?

U=U stands for “Undetectable equals Untransmittable.” Scientific evidence confirms that when people living with HIV are on effective treatment and maintain an undetectable viral load, they cannot transmit HIV through sex (See articles by Rodgers et al and HPTN052 results). This groundbreaking understanding has opened new doors for sex and growing your family.

Why is U=U important for parenthood?

Knowing that an undetectable viral load prevents HIV transmission provides reassurance and freedom for people and couples considering condomless sex. Regular checkups with healthcare providers—including blood tests—are essential to ensure the viral load stays undetectable. Data from the Canadian AIDS Treatment Information Exchange (CATIE) in 2022 shows that approximately 95% of people diagnosed with HIV who are on treatment have achieved viral suppression, making condomless sex a safe option for conception for many people living with HIV in Canada.

The Role of PrEP in Safe Conception - What is PrEP?

HIV Pre-exposure Prophylaxis (PrEP) involves taking antiretroviral medication daily to reduce the risk of HIV transmission in HIV-negative partners (see CATIE for more information of PrEP). When one partner has a detectable viral load or when viral suppression isn’t certain, PrEP provides an additional layer of protection.

How does PrEP support conception?

When a person living with HIV isn’t yet virally suppressed, or when there are concerns about adherence, PrEP can be a crucial tool. It empowers couples to pursue condomless sex confidently, knowing that the HIV-negative partner’s risk of acquiring the virus is minimized.

Important: Discussing PrEP with your healthcare provider ensures informed decisions and optimal protection for both partners.

Timing and Tracking Ovulation for Conception

Understanding menstrual cycles and ovulation is vital for maximizing chances of pregnancy. Ovulation typically occurs around the middle of the cycle when an ovary releases an egg. Tips for timing condomless sex:

• Track menstrual cycles and identify your fertile window. You can use apps or a calendar to do this. Check out our resource on Ovulation 101 to learn how to track your cycle.

• Engage in condomless sex during this “fertile window,” usually a few days around ovulation

• Using ovulation predictor kits or monitoring basal body temperature can help pinpoint the best days to conceive

Tips and Expectations for a Safe Journey to Parenthood

• Consult your healthcare provider before starting condomless sex to confirm your viral load status

• Maintain open communication with your partner about concerns, expectations, and health status

• Coordinate timing with ovulation tracking to optimize conception chances

• Prioritize emotional well-being—the journey can evoke feelings of hope, anxiety, or fear. Support from healthcare providers, counselors, or peer groups can provide reassurance

Moving Forward with Confidence

Condomless sex, guided by scientific understanding and medical guidance, can be a safe and effective pathway for individuals living with HIV to become parents. By maintaining an undetectable viral load, considering PrEP when appropriate, and fostering open communication, couples can pursue their dreams confidently and safely.

As awareness and education continue to grow, more people living with HIV will have the opportunity to build families, nurture relationships, and embrace the joys of parenthood. The future is filled with possibilities—hope, love, and new beginnings await.

To learn more about Pathways to Parenthood, visit us online or follow up on Instagram @hivparentingchoices.