Guide | Healthy Pregnancy and Family Building for People With HIV
People with human immunodeficiency virus (HIV) can have children. With appropriate care and medication, they can have a healthy pregnancy and birth without transmitting the virus to a partner or child.
Dr. Monica Hahn, an HIV specialist and associate clinical professor of family and community medicine at the University of California, San Francisco, said major medical advances mean that people who consistently take medication can generally expect a healthy pregnancy and birth and a baby unaffected by HIV.
If you or your partner has HIV and plans to conceive, discuss your treatment with your HIV doctor. If you become pregnant, tell your HIV doctor immediately to support your health and your baby's health.
1. Undetectable Equals Untransmittable
In the past, conceiving without risking transmission to an HIV-negative partner could require procedures such as IUI and fertility treatment. HIV specialists now follow the “U=U” principle: undetectable equals untransmittable. Maintaining an undetectable viral load means HIV is not transmitted through sex.
Dr. Hahn described this as a breakthrough that allows people with HIV to have healthy, fulfilling sex lives and family lives.
She added that people who remain on HIV medication can have healthy pregnancies and children unaffected by HIV, a far more encouraging outlook than a decade ago.
U=U also applies to transmission from a pregnant person to a baby. If an undetectable viral load is maintained before and during pregnancy and at delivery, the risk is nearly zero. Dr. Judy Levison, professor of obstetrics and gynecology at Baylor College of Medicine and an expert in HIV and pregnancy, said no transmission to a baby has been reported in this situation.
2. Conceiving With a Partner
If you have HIV and want to become pregnant, take antiretroviral medication consistently and reach an undetectable viral load. After maintaining it for 3–6 months, you can have sex without a condom to conceive without risk of transmitting HIV.
If your partner has HIV and you want to conceive using his sperm, the same approach is recommended: he should take medication, maintain an undetectable viral load, and then try to conceive.
If you do not have HIV but your partner does, ask your doctor about pre-exposure prophylaxis (PrEP). PrEP is a daily pill that reduces the chance of acquiring HIV and is safe during pregnancy and breastfeeding.
3. Pregnancy and Delivery Planning
Many HIV medicines are safe during pregnancy, so you may be able to continue the same treatment. Viral load should be checked frequently—every one or two months—to confirm it remains undetectable. If it rises, the doctor may adjust the medicine or dose.
Delivery is generally similar for people with and without HIV. Vaginal delivery is possible if viral load is below 1000 at delivery. If it is above 1000, cesarean delivery is needed to reduce the baby's risk of acquiring HIV.
After birth, the baby should receive AZT for 4 weeks to prevent HIV and be tested at birth, 2 weeks, 4 weeks, and 4 months.
Historically, breastfeeding was not recommended for people with HIV, and official U.S. guidance remained unchanged from 1985. Dr. Levison noted that many parents want to breastfeed. If a person whose HIV is controlled with medication wishes to breastfeed, the doctor should discuss the options and support informed decision-making.
4. Other Ways to Build a Family
People with HIV can use any fertility treatment, including in vitro fertilization (IVF) and egg freezing. Sperm used in fertility treatment is usually “washed” before use to remove HIV from the semen.
Fertility clinics can also help build a family through options such as donor-egg insemination or a gestational carrier.
Adoption is another option. Under the Americans with Disabilities Act, adoption agencies may not discriminate against people with HIV.
Guide | Healthy Pregnancy and Family Building for People With HIV
Guide | Healthy Pregnancy and Family Building for People With HIV
People with human immunodeficiency virus (HIV) can have children. With appropriate care and medication, they can have a healthy pregnancy and birth without transmitting the virus to a partner or child.
Dr. Monica Hahn, an HIV specialist and associate clinical professor of family and community medicine at the University of California, San Francisco, said major medical advances mean that people who consistently take medication can generally expect a healthy pregnancy and birth and a baby unaffected by HIV.
If you or your partner has HIV and plans to conceive, discuss your treatment with your HIV doctor. If you become pregnant, tell your HIV doctor immediately to support your health and your baby's health.
1. Undetectable Equals Untransmittable
In the past, conceiving without risking transmission to an HIV-negative partner could require procedures such as IUI and fertility treatment. HIV specialists now follow the “U=U” principle: undetectable equals untransmittable. Maintaining an undetectable viral load means HIV is not transmitted through sex.
Dr. Hahn described this as a breakthrough that allows people with HIV to have healthy, fulfilling sex lives and family lives.
She added that people who remain on HIV medication can have healthy pregnancies and children unaffected by HIV, a far more encouraging outlook than a decade ago.
U=U also applies to transmission from a pregnant person to a baby. If an undetectable viral load is maintained before and during pregnancy and at delivery, the risk is nearly zero. Dr. Judy Levison, professor of obstetrics and gynecology at Baylor College of Medicine and an expert in HIV and pregnancy, said no transmission to a baby has been reported in this situation.
2. Conceiving With a Partner
If you have HIV and want to become pregnant, take antiretroviral medication consistently and reach an undetectable viral load. After maintaining it for 3–6 months, you can have sex without a condom to conceive without risk of transmitting HIV.
If your partner has HIV and you want to conceive using his sperm, the same approach is recommended: he should take medication, maintain an undetectable viral load, and then try to conceive.
If you do not have HIV but your partner does, ask your doctor about pre-exposure prophylaxis (PrEP). PrEP is a daily pill that reduces the chance of acquiring HIV and is safe during pregnancy and breastfeeding.
3. Pregnancy and Delivery Planning
Many HIV medicines are safe during pregnancy, so you may be able to continue the same treatment. Viral load should be checked frequently—every one or two months—to confirm it remains undetectable. If it rises, the doctor may adjust the medicine or dose.
Delivery is generally similar for people with and without HIV. Vaginal delivery is possible if viral load is below 1000 at delivery. If it is above 1000, cesarean delivery is needed to reduce the baby's risk of acquiring HIV.
After birth, the baby should receive AZT for 4 weeks to prevent HIV and be tested at birth, 2 weeks, 4 weeks, and 4 months.
Historically, breastfeeding was not recommended for people with HIV, and official U.S. guidance remained unchanged from 1985. Dr. Levison noted that many parents want to breastfeed. If a person whose HIV is controlled with medication wishes to breastfeed, the doctor should discuss the options and support informed decision-making.
4. Other Ways to Build a Family
People with HIV can use any fertility treatment, including in vitro fertilization (IVF) and egg freezing. Sperm used in fertility treatment is usually “washed” before use to remove HIV from the semen.
Fertility clinics can also help build a family through options such as donor-egg insemination or a gestational carrier.
Adoption is another option. Under the Americans with Disabilities Act, adoption agencies may not discriminate against people with HIV.
Source:
Collected online