Thanks to the effectiveness of medication in reducing viral loads, more and more people living with HIV are choosing to become parents without having the same fears about passing HIV to their child.
Maintaining an undetectable viral load during pregnancy and early childhood significantly reduces the chances of a child acquiring HIV. This requires careful planning and working with your specialist before conception and through early infancy.
HIV and conception
If you are taking HIV treatment and your (or your partner’s) viral load is undetectable, the risk of passing HIV on during vaginal sex without a condom is negligible.
Find out more about undetectable equals untransmittable at our U=U page.
It’s a good idea to talk to your doctor for information and advice specific to you and your situation.
Pregnancy
Maintaining a low and preferably undetectable viral load during pregnancy reduces the risk of HIV being passed on to your baby.
During pregnancy, if the parent is not accessing treatment there is about a 20% chancing of passing on HIV to the baby. This drops to less than 1% with an undetectable viral load.
If you are already taking HIV treatment, you can generally continue taking the same treatment throughout your pregnancy. If you are not already taking HIV treatment, your HIV doctor will recommend that you start taking treatment during your pregnancy.
Complications during pregnancy, as well as certain procedures can increase the risk of HIV transmission. Your specialist will be able to work directly with you to decrease those risks.
HIV and childbirth
If you are on treatment and have a low viral load, vaginal and caesarean births are both generally safe.
If you are not on treatment or have a high viral load, your doctor is likely to recommend a planned caesarean delivery. This will reduce the amount of blood your baby comes in contact with.
The majority of babies born to HIV positive women do not acquire HIV.
Breastfeeding and HIV risk
HIV can be present in breastmilk and can be transmitted to the baby, especially if they are teething.
Breastfeeding comes with many health benefits for babies but it is important to discuss with your specialist about your options.
Maintaining an undetectable viral load decreases the likelihood of transmission but there still is a risk.
Generally in countries such as Australia, where there are safe alternatives to breastfeeding, HIV positive mothers are strongly advised to use these rather than to breastfeed.
Check out NAPWHA’s Living Well resource on breastfeeding and living with HIV.
Who can I talk to for support?
If you are pregnant or want to know what your parenting options, you can contact us. We can link you in with the right specialist to support you.