Summary of key points

• Reproductive desires and choices are a primary concern following heterosexual diagnosis of HIV
• HIV adds to the complexity of reproductive decision-making
• Effective treatment and management can greatly reduce the risk of transmission to sexual partners
• Preconceptual counselling should include a discussion on the risks and benefits of different choices for conception
• Individuals' negotiate risk by balancing biomedical understanding (viral load) with broader social expectations and desires

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