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HIV and pregnancy

6-minute read

How do I plan a pregnancy if I’m HIV positive?

If you are living with HIV, you can have unprotected sex (sex without a condom) in order to become pregnant, but only if you are taking antiretroviral treatment and you have a sustained undetectable viral load.

More than 20 years of scientific evidence shows that there is no risk of HIV transmission to your negative partner when you have what is called Undetectable equals Untransmissable (U=U). The U=U message was recognised globally in 2016.

Read more about U=U.

If you are thinking about becoming pregnant, you and your partner should be checked for any sexually transmitted infections, and have any such infections treated.

If your partner is still concerned about the risk of HIV transmission from unprotected sex, they can take a pre-exposure prophylaxis called PrEP. PrEP is an anti-HIV medication that is taken by a person who does not have HIV to lower their risk of infection.

Ask your doctor for more information about PrEP.

How is the risk of transmission reduced during pregnancy?

If you have HIV and are taking ARV medications and have an undetectable viral load, it’s possible for you to have a healthy pregnancy and for your baby to be born healthy and HIV negative.

To ensure you have a healthy pregnancy and your baby is born HIV negative, you need to:

  • take ARV medicines during your pregnancy to achieve an undetectable viral load
  • attend all your appointments with your HIV specialist doctor who will coordinate your regular blood tests
  • attend all your appointments with your infectious diseases specialist doctor who specialises in the care of women living with HIV and pregnancy or an obstetrician who may also specialise in HIV and pregnancy

Like all women who are pregnant, to ensure your health and the health of your unborn your baby, it is important that you eat a healthy diet, live a stress-free lifestyle, get plenty of rest and regular exercise.

If you are diagnosed with HIV during pregnancy, it’s important you talk to your doctor immediately so you can begin taking ARV medications to reduce the risk of your baby contracting HIV. ARV treatment can be started even if you find out late in your pregnancy that you’re HIV positive. Women who have HIV while pregnant and take antiretroviral medicines ensure they do not transmit HIV to their baby. In fact, in Australia no baby has been born HIV positive when the mother is taking ARV medicines and has a sustained undetectable viral load.

How do we plan a pregnancy if my partner is HIV-positive?

When the male partner has HIV, they can not transmit HIV to their partner (regardless of gender), providing they are taking ARV medicines and has an undetectable viral load.

The HIV-negative partner can also take PrEP before and while they are trying to get pregnant if they are still concerned about HIV transmission.

How is the risk of transmission reduced during labour?

You have a choice about how to have your baby, although your doctor will advise about options for labour depending on your health and other factors.

The safest way to deliver your baby — whether by vaginal or caesarean delivery — depends on whether you have an undetectable viral load or how much HIV is in your blood. In general, a vaginal delivery is preferred for both your safety and your baby’s safety if the risk of transmission of HIV is low.

If you have a high level of the virus in your blood (such as if you were diagnosed late in your pregnancy and you have not yet achieved an undetectable viral load while taking ARV medicines), a caesarean section is recommended.

You can also have a planned caesarean if that’s your wish even if you have an undetectable viral load.

How do I reduce the transmission risk to my newborn baby?

After your baby is born, they will usually be given ARV medicines as a small amount of syrup twice a day for about 2 to 4 weeks. This medicine is given as an added precaution to protect your baby just in case HIV was transmitted during pregnancy or during birth.

On the day your baby is born, they will be tested to find out if they developed HIV during pregnancy. Your baby will generally be tested again at 6 weeks, 3 months, 12 months and at 18 months.

How do I feed my baby?

Formula feeding is the safest way to feed your baby because HIV can be transmitted through breast milk.

Scientific research from around the world suggests that the risk of HIV transmission through breast milk is extremely low when the mother is taking ARV medicines, has a sustained undetectable viral load and is supported by their healthcare team.

However, this does not reduce the risk completely. Breast infections, an upset tummy in the mother or the baby or forgetting to take medications on time all increase the level of HIV in the breastmilk, which increases the risk of transmission to the baby.

In Australia, even if you are taking HIV medications, breastfeeding is not recommended.

If you do decide to breastfeed your baby, healthcare professionals experienced with HIV and breastfeeding and HIV support organisations, can support you.

If you have any questions about your risk of transmitting HIV to your baby through breastfeeding, talk to your HIV specialist experienced with mothers living with HIV and breastfeeding.

Read more about living with HIV and breastfeeding from PositiveWomen.

Where can I go for more information and support?

Information is available for anyone living with HIV and who is pregnant or wants to have children. In addition to speaking with your specialists, you can also contact:

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: August 2023

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Pregnancy and Breastfeeding - Positive Women Victoria

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