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Jennifer Power has previously received research funding from the Australian Research Council, VicHealth, Relationships Australia and ACON. PrEP is a game-changer for couples where one person is HIV positive, allowing natural conception with minimal risk. A new pill could enable people living with HIV to conceive children through sex without risking the health of their HIV-negative partner. The well-managed use of ART means mother-to-child transmission of HIV is rare in Australia. For a person living with HIV, however, achieving a pregnancy is not without its complications.
For heterosexual people in a sero-discordant relationship (where one person is HIV-positive, the other HIV-negative), options for conceiving children have tended to be either expensive or risky. Research has so far shown that, taken correctly, PrEP significantly reduces a person’s chance of acquiring HIV.
For this reason, the emergence of PrEP has been controversial – particularly within the gay community.
Others have echoed Duran’s sentiment, citing concerns that PrEP provides licence to be irresponsible, undermining years of effort to legitimise condom use and risking an increase in rates of other sexually transmitted infections.
For sero-discordant couples wanting to conceive children, PrEP is undoubtedly a game-changer, allowing natural conception with minimal risk. But people living with HIV and their partners still encounter stigma if they decide to have children. In her book on HIV and pregnancy, Positively Negative, journalist Heather Boerner recounts the story of Poppy Morgan (not her real name), an American woman with a HIV-positive partner.
To be fair, in 2010 there was limited information available about PrEP and this doctor may well have been acting out of concern for Morgan. While Truvada may currently be prescribed to HIV-positive Australians, its use as a preventive treatment for HIV-negative people has not yet been approved, though the manufacturer has submitted an application to the Therapeutic Goods Administration. If approved for use, Truvada will need to be assessed by another body to determine whether it will be subsidised under the Pharmaceutical Benefits Schedule. While PrEP may not radically change the landscape of HIV prevention in Australia – condoms will always be important – it will certainly provide a significant new reproductive option for people living with HIV.


Nothing is so hard for those who abound in riches as to conceive how others can be in want. In 1859, the thing to do was to accept Darwinism; now many biologists are revolting and trying to conceive of something else. How can one conceive of a one-party system in a country that has over two hundred varieties of cheese?
The animals did not conceive -- the mother hogs, the sows -- the baby pigs were not born last fall and into the winter.
It's hard to envisage how even any kind of technology we can conceive of now could harness this. I cannot conceive a more acute pain in the power of sentiment to inflict than that which I should feel if, after a life passed in England or the colonies or India, I were to come back to my native mountains and find that the indifference or the actual discouragement of our leaders had succeeded in destroying the language of my childhood.
It took a tremendous amount of faith to conceive this idea, and then start it from scratch and make it happen.
Disclaimer: Magazine subscription prices shown are as a guide only, usually based on a 12 month subscription (although do check). We use a Creative Commons Attribution NoDerivatives licence, so you can republish our articles for free, online or in print. But the incredible success of antiretroviral treatment (ART) means most Australians diagnosed with HIV assume a long and healthy life, along with the milestones of sex, relationships and family. While we don’t have the data for children born to HIV-positive fathers, there are likely to be many more.
Condoms are central to safe sex – the main protection against transmission of HIV – but of course condoms also protect against pregnancy.
At the expensive end are fertility treatments, such as sperm washing and in vitro fertilisation.
If the HIV-positive partner is on ART and the virus has been suppressed in their system, then recent studies suggest this can be a relatively safe option.
Pre-exposure prophylaxis (PrEP) is a course of a combination ART drug called Truvada that HIV-negative people take to prevent them becoming infected.
PrEP has been described as a sexual game-changer: a pill that re-introduces the possibility of “safe” sex without condoms.


In a now-infamous 2012 Huffington Post piece, writer David Duran coined the term “Truvada whores" – pointing largely to gay men who, Duran argued, will use PrEP simply to continue having unsafe sex. While it might not offer a global solution to stopping HIV, it certainly presents an effective prevention option for people at high risk of acquiring HIV.
Evidence to date supports the safety and efficacy of PrEP for sero-discordant couples trying to conceive and it’s seen as a sensible choice.
But Morgan felt shamed by this encounter and judged for her sexual choices and maternal longing. In her Australian-based research with HIV-positive women, Karalyn McDonald found many women had friends or family who objected to their decision to have children, arguing it was selfish and put children at risk.
There is a need to promote respectful understanding of the reproductive and parenting choices made by people living with HIV. The Xerox Aspiring Authors program recognizes the people who conceive the ideas, create the stories, drive the new business models, and leverage the new technology that is creating a sea change in digital publishing. There will always be linkage and I can conceive of no possibility in which there will not be linkage, and I am increasingly concerned about how we will get to that point.
One woman in the study told people she had fallen pregnant accidentally to avoid having to justify her decision to pursue a second pregnancy. The only thing we can envision now is to sit back and behold the wonder of nature at being able to do this. Each gorgeous feel-good issue is packed with the latest pregnancy health information, on-trend maternity fashion and beauty for every bump, inspirational real-life stories, and comprehensive shopping guides to all the newest and best baby products.
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