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HIV, pregnancy and childbirth

Women with HIV can have healthy, HIV-negative babies.  

Attend your antenatal appointments so that you can test for HIV. 

If you test positive, take treatment during pregnancy and breastfeeding to stop passing HIV to your baby. 

Can people with HIV have a family?

Yes. Taking antiretroviral treatment properly during pregnancy means women with HIV can have healthy pregnancies and give birth to healthy, HIV-negative babies.  

I’m pregnant or planning to get pregnant. How do I know if I have HIV?

The only way to know if you have HIV is to get tested. Attend your antenatal appointments, as this is when you can get an HIV test. Your healthcare professional will offer you a test: 

  • at your first appointment 

  • in your third trimester (from 28 weeks) 

  • after delivery of your baby 

If the result is positive, start antiretroviral treatment as soon as possible. 

I have HIV and am pregnant. How can I stop passing HIV to my baby?

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Taking the correct treatment during your pregnancy and while you breastfeed will reduce the risk of passing HIV to your baby to almost zero. Without treatment, there is a 15 - 45% chance of passing HIV on to your baby through: 

  • pregnancy 

  • childbirth 

  • breastfeeding.

Prevention of mother-to-child transmission of HIV (PMTCT)

Is HIV treatment safe during pregnancy?

Yes. Taking antiretroviral treatment (ART) during pregnancy: 

  • is safe for you and your baby 

  • keeps the level of HIV in your body low, so you stay healthy  

  • protects your baby from HIV  

  • reduces your risk of passing HIV on through sex.  

Guidelines recommend starting ART as soon as possible after you’re diagnosed with HIV. You should take ART for life, not just while you are pregnant. 

Can I have a normal birth?

It’s usually recommended that women with HIV give birth naturally (vaginal birth). If a vaginal birth would be difficult, it may be safer to have a caesarean section. This is an operation to remove the baby from your womb. If you have a high viral load, you may also be advised to have a caesarean section. Your healthcare provider will advise the best way to deliver your baby. 

If you will give birth at home, visit a healthcare provider as soon as possible after the birth so that they can check your health and your baby’s health, test them for HIV, and start them on a short course of treatment to prevent HIV. It’s important that your baby takes this treatment. 

Does my baby need treatment?

Yes. After birth, all babies born to mothers with HIV will need to take HIV treatment for 4–6 weeks. 

Can I breastfeed my baby?

Antiretroviral treatment reduces the amount of HIV in breastmilk, reducing the risk of passing on HIV through breastfeeding. However, advice on breastfeeding varies depending on where in the world you live and the resources available to you. Speak to a healthcare professional for advice on what feeding method is right for you and your baby. 

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How do you conceive in a mixed status couple without passing on HIV?

A mixed status couple is when one partner has HIV, and the other doesn’t. You can conceive a baby and prevent passing HIV to the negative partner by following this advice:  

If the woman is HIV-positive and the man is HIV-negative 

  • The woman should take HIV treatment to reduce her viral load which will reduce the risk of passing HIV to the man. She will need to have an undetectable viral load before having unprotected sex. 

  • The man should take PrEP to prevent getting HIV from the woman before having unprotected sex. 

  • Instead of having unprotected sex, a doctor can put the man’s sperm into the woman’s vagina using a syringe. This is called artificial insemination. 

If the woman is HIV-negative and the man is HIV-positive 

  • The man should take HIV treatment to reduce his viral load which will reduce the risk of passing HIV to the woman. He will need to have an undetectable viral load before having unprotected sex. 

  • The woman should take PrEP to prevent getting HIV from the man before having unprotected sex. 

  • Instead of having unprotected sex, a doctor can combine the egg and sperm outside the body and then put it into the woman’s uterus. This is called in vitro-fertilisation (IVF). 

  • Instead of having unprotected sex, a doctor can separate the sperm (which doesn’t contain HIV) from the seminal fluid (which does contain HIV) and put the sperm into the woman’s vagina. This is called sperm washing. 

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