Undetectable HIV and surrogacy
On 22 October 2024, new regulations passed through both the House of Commons and the House of Lords, allowing intended parents living with HIV – provided they are on a stable and established programme of medication to make their viral load undetectable – to have a biological child through UK surrogacy.
We’d like to share some information about what this might mean for anyone considering becoming a surrogate.
What do we mean by “undetectable HIV”?
Current HIV treatments are highly effective in improving the health of people living with HIV and reducing transmission of the virus.
For most people living with HIV, antiretroviral medicines reduce the amount of HIV in the blood to levels that are undetectable.
A person living with HIV who is on antiretroviral therapy and has an undetectable viral load cannot pass HIV sexually to their partners.
This is often referred to as Undetectable = Untransmittable or (U = U).
There have been no cases of transmission of HIV where someone has a U = U status.
How is “undetectable HIV” measured?
n undetectable viral load for HIV is measured through a blood test that quantifies the amount of HIV in the blood. The results are expressed as the number of viral copies per milliliter of blood.
- Undetectable Level: An undetectable viral load means the level of HIV in the blood is so low that it cannot be detected by standard tests.
- Threshold: The specific threshold for undetectable varies, but it’s typically considered to be below 200 copies/mL. Some newer tests can detect even lower levels.
- Regular Monitoring: People living with HIV who are on effective treatment should have regular viral load tests to ensure their viral load remains undetectable.
For surrogacy this test is repeated at key intervals and should come back as undetectable each time.
What does this mean for your surrogacy journey?
If you’re considering surrogacy for intended parents living with undetectable HIV, it’s important to know about the specific regulations regarding donation:
- IPs must have Undetectable Viral Load: If the intended parents have an undetectable viral load, they can legally donate sperm, eggs, or embryos to you. This ensures the safety of both you and the potential child.
- Health Checks: Both the intended parents and you will undergo standard health checks. In addition their viral load will be checked. With an undetectable viral load, they are eligible to donate, even if they are HIV-positive.
- Blood Tests: The intended parents will need to provide two blood tests to confirm their low viral load. The first test should be taken between 6 months and 21 days before donation, and the second within 7 days of donation.
- Consistent Treatment: The intended parents must have been on consistent antiretroviral treatment for at least 6 months prior to donation.
By understanding these guidelines, you can make informed decisions and feel confident in your role as a surrogate.
BB has been working with parents who are living with undetectable HIV for a number of years to begin their families through US surrogacy, and we are now pleased that these parents can conceive in the UK with the help of a UK surrogate.
Is there a risk of developing HIV for surrogates?
The risk of HIV transmission to a surrogate from a gamete donor with an undetectable viral load is extremely low, and considered to be negligible. This is due to the effectiveness of antiretroviral therapy (ART) in suppressing the virus to undetectable levels.
- Undetectable = Untransmittable (U=U): Extensive research has shown that people living with HIV who have an undetectable viral load cannot sexually transmit the virus.
- Strict Regulations: donation from people with HIV is subject to strict regulations to ensure safety. Donors must have a sustained undetectable viral load and have been on anti retroviral for a specific period.
- Regular Monitoring: Donors with HIV undergo regular monitoring to ensure their viral load remains undetectable.
While there is always a small theoretical risk, the actual risk for surrogate from a donor with an undetectable viral load is considered to be virtually nonexistent.
Want to chat with us about being a surrogate?
Tracey, our Surrogate Manager has supported thousands of women considering becoming surrogates.
She is always happy to have a chat with you.
She loves talking about her experience, the benefits of working with Brilliant Beginnings and how the surrogacy works in the UK.
There are no silly questions!
Where can you get more information?
Our bespoke and thorough one to one matching process means we give you detailed information about the intended parents we propose as a match, including information about their health, and it’s completely your choice whether to proceed. This sets a strong foundation for your relationship with BB and your IPs.
The following organisations also support surrogates and intended parents to make evidence based decisions regarding undetectable HIV:
By Donna McParland
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