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Abstract:

Objective To explore the risk of transmission of HIV through unprotected sexual intercourse for childbearing purpose in married or unmarried serodiscordant couples in which the male partner has tested posi⁃ tive for HIV. Methods The male partners of 58 couples had received antiretroviral therapy（ART）for more than one year. Under the condition of HIV⁃1 RNA being < 20 copies/mL and CD4+ T lymphocyte count > 250 cells/μL， the couples who desired to have children had vaginal intercourse without condoms. The female partners were informed in advance the risk of HIV infection and the prevention methods and did not take prophylactic medications before and after sexual contact. They had sex without condom use 2 to 3 times during the period of ovulation for less than 6 months，and HIV antibodies were tested 3，6，12，and 18 months after their last sexual intercourse. Results 58 HIV⁃positive male patient［ages from 23 to 45 years，an average age of（31.6 ± 4.9）years］received ART for 12 to 48 months（a median of 18 months）. HIV⁃1 RNA was less than 20 copies/mL in peripheral blood and in semen at least once. The average count of CD4 + T⁃lymphocyte（518.4 ± 167.4）cells/μL after the therapy was markedly greater than the baseline［（310.7 ± 130.6）cells/μL，t = 10.281，P＜0.001］. All the patients had unprotected sex with their partners for 3 to 6 months（median：6 months）. All the female partners were tested negative for HIV antibodies and 4 of them became pregnant. Two infants were tested negative for HIV antibodies. Conclusions Men who are successfully treated with ART have a relatively low risk of passing HIV to his hetero⁃ sexual partner by sex.

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