It is tricky, but possible. Some couples who are of mixed HIV status--that is, one partner is infected and the other one isn't--take a chance and have unprotected sex in order to conceive a baby. Sometimes, they restrict their unprotected sex to times when they are pretty sure the woman is ovulating. This maximizes her chance of getting pregnant while minimizing the number of times they have unprotected sex. If the HIV-positive partner is on anti-HIV drugs and has an undetectable viral load, this may offer some protection against infecting the other partner. But that really is not known, because there still can be HIV in semen and vaginal fluids even when it is undetectable in the blood.

Bottom line: Having unprotected sex to have a baby poses a risk of passing the virus to the uninfected partner.

Another option is to seek assistance at a fertility clinic. Some fertility clinics offer (for a fee) a sperm-washing program for HIV-infected men or an artificial insemination program for HIV-infected women, so that couples of mixed HIV status can try to conceive a child without exposing the uninfected partner to HIV. This is legal in some states, but not all.

HIV-infected women who become pregnant, regardless of the method, should still seek prenatal care in a program with experience in preventing mother-to-child transmission of HIV. (See: Can two HIV-positive parents have an HIV-negative child?)