Can I Use a Surrogate if I’m HIV positive?

Let’s get this out of the way right up front: Yes, you can form your family through surrogacy even if you are HIV positive! This is just one of the many ways the world looks different today for people living with the HIV virus—when the diagnosis was, for most, a death sentence. Today, most people living with HIV (at least those with access to life-saving drugs) can lead long, happy productive lives, like anyone else—and can become biological parents like anyone else These are truly remarkable developments, particularly to those who lived through the height of the epidemic and are still here to tell their stories.

There are several safeguards in place—including “sperm washing,” antiviral therapies—that prevent those living with HIV from transmitting the virus to either their baby or surrogate during the surrogacy process. Let’s review the ways that HIV-positive individuals are able to become biological parents below:

Antiretroviral Treatments: Undetectable = Untransmissable

Antiretroviral treatments mean that many people living with HIV now have what’s called an “undetectable” level of the virus within their bodies. This means the virus has been reduced to such an insignificant amount in the body that it can’t be detected by standard blood tests, or be passed on to others. Research has shown that people living with HIV who have undetectable viral loads are unable to pass the virus on to their partners or a child conceived through sex. This truth is often represented online and elsewhere with the shorthand U=U, meaning “Undetectable” equals “Untransmissable.” Despite this huge breakthrough (which also helps ensure those living with HIV can live long, normal, healthy lives) there are additional precautions HIV-positive people often take to ensure the virus is not transmitted to their partners or baby.

Sperm Washing

An HIV-positive person who hopes to contribute sperm as part of a surrogacy journey can subject their specimen to a procedure known as “sperm washing,” which eliminates the risk of transmission to the gestational carrier or the baby.

After collecting semen from the HIV-positive partner, the specimen then undergoes a process, through what’s known as centrifugation, to separate the sperm from the seminal fluid. Since the HIV virus is present in the seminal fluid, and not the sperm, this eliminates the risk of HIV transmission to either the gestational carrier in a surrogacy arrangement or the resulting child. One study which included 914 couples who underwent this procedure found no instance of HIV infection among the women, or the resulting children conceived, after the sperm-washing procedure.