Preventing Perinatal Transmission of HIV
Can a Pregnant Person Transmit HIV to Their Baby?
Yes. An HIV-positive person can transmit HIV to their baby any time during pregnancy, childbirth, or breastfeeding. But that doesn’t mean that you can’t have children.
Treatment with a combination of HIV medicines (called antiretroviral therapy or ART) can prevent transmission of HIV to your baby and protect your health.
How Can You Prevent Transmitting HIV to Your Baby?
If you are HIV-positive, there are several steps you can take to reduce your risk of transmitting HIV to your baby.
Get Tested for HIV As Soon As Possible to Know Your Status
- If you are pregnant or planning to get pregnant, get tested for HIV as early as possible during each pregnancy. Knowing your HIV status gives you powerful information.
- If you learn you have HIV, the sooner you start treatment the better—for your health and your baby’s health and to prevent transmitting HIV to your partner.
- If you learn you don’t have HIV, but you are at increased risk of acquiring it, get tested again in your third trimester.
- You should also encourage your partner to get tested for HIV.
HIV-negative but at Risk? Take Medicine to Prevent HIV
- If you have a partner with HIV and you are considering getting pregnant, talk to your health care provider about pre-exposure prophylaxis (PrEP).
- PrEP is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use. PrEP can stop HIV from taking hold and spreading throughout your body.
- PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding. Find out if PrEP is right for you.
- If your partner has HIV, also encourage them to get and stay on HIV medicine. This will keep them healthy and help prevent them from transmitting HIV to you.
HIV-positive? Take Medicine to Treat HIV
- Taking HIV medicine reduces the amount of HIV in your body (your viral load) to a very low level, called viral suppression. If your viral load is so low that a standard lab test can’t detect it, this is called having an undetectable viral load. Taking HIV medicine and getting and keeping an undetectable viral load is the best thing you can do to stay healthy and prevent transmission to your baby.
- If you have HIV and take HIV medicine as prescribed throughout your pregnancy and childbirth and give HIV medicine to your baby for 4 to 6 weeks after giving birth, your risk of transmitting HIV to your baby can be less than 1%.
- If your HIV viral load is not adequately reduced by HIV medicine, a cesarean delivery (sometimes called a C-section) can also help prevent HIV transmission.
- Taking HIV medicine substantially reduces, but does not eliminate, the risk of transmitting HIV through breastfeeding. The current recommendation in the United States is to avoid breastfeeding.
- Taking HIV medicine also protects your HIV-negative partner. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex.
Are HIV Medicines Safe for You to Use During Pregnancy?
Most HIV medicines are safe to use during pregnancy. Talk with your health care provider about the benefits and risks of specific HIV medicines when deciding which HIV medicines to use during pregnancy or while you are trying to get pregnant.
Can You Breastfeed if You Have HIV?
The current recommendation in the United States is that people with HIV should not breastfeed or pre-chew food for their babies. In the United States, infant formula is a safe and readily available alternative to breast milk. Keeping an undetectable viral load substantially reduces, but does not eliminate, the risk of transmitting HIV through breastfeeding. If you have questions about breastfeeding or desire to breastfeed, talk to your health care provider about infant feeding options. Learn more about HIV and breastfeeding here.
What Should You Ask Your Health Care Provider About Having a Baby?
You might ask your health care provider some of these questions:
- What is the safest way to conceive?
- Will HIV cause problems for me during pregnancy or delivery?
- Will my HIV treatment cause problems for my baby?
- What are the pros and cons of taking HIV medicine while I am pregnant?
- Is my viral load undetectable?
- How do I avoid transmitting HIV to my partner(s), surrogate, or baby during conception, pregnancy, and delivery?
- What medical and community programs and support groups can help me and my baby?
- What birth control methods are best for me?
If you or your partner has HIV and is thinking about getting pregnant, you should talk to your health care provider as soon as possible about taking PrEP. If you’re not already taking it, PrEP may be an option to help protect you or your partner from getting HIV while you or your partner try to get pregnant, during pregnancy, or while breastfeeding.
Adopting a baby is also an option for people with HIV who want to begin or expand their families. The Americans with Disabilities Act does not allow adoption agencies to discriminate against individuals or couples with HIV.