Dear Doctor, 

I have a fiancée, whom I have been with for a year. We used to have live sex till August last year, when her uncle declared to her that she was HIV-positive and that her parents died of AIDS when she was still young. She went for a test and that status was confirmed. 

 

The girl is 21, but has no signs of HIV. I also went for a test and the results turned out negative. I promised to marry her no matter what happened. Is it possible for us to live together and have children? 

 

Dear Jonathan,

Discordant couples, where one is HIV-positive and the other is HIV-negative, can happily live together. However, love should not overshadow the need for you to remain healthy and HIV-negative. In this situation, having children can be achieved through artificial insemination during the woman’s most fertile days. 

 

Sperm washing is also encouraged where a man is HIV-positive and the woman is HIV-negative. The two of you had live sex and you remained HIV-negative, it could be that her viral load was still low and her CD4 count was high, but there is no guarantee that you will not acquire HIV if you continued having live sex. 

 

Safer sex, where you use condoms all the time would be better in this relationship. If, by any coincidence, live sex takes place, post-exposure prophylactic treatment should be sough immediately. 

 

Your partner should be medically assessed for antiretroviral therapy or any other treatment to reduce HIV sexual transmission and improve on her immunity. Medical assessment of the HIV-positive woman is paramount before conception, during pregnancy, labour, delivery and the time of breastfeeding to prevent mother-to-child HIV transmission.