Starting a Family When You Have HIV

If you’re living with HIV and you’re contemplating having children it is possible. With the proper treatment and care, those who live with HIV can enjoy healthy babies and healthy pregnancies without passing HIV in the course of children or a spouse.

“We’ve come to a place where we have really wonderful medications and medical advances that advocates of the past have fought hard to get us,” says Monica Hahn, MD, an HIV specialist and associate Professor of community and family medicine at the UCSF School of Medicine.

“Now if you can consistently take your medicines, you can have essentially a normal and healthy pregnancy, delivery, and baby – a baby free of HIV,” she adds. “We can essentially guarantee that.”

If you’re looking to become expecting and you or your partner are both suffering from HIV consult the HIV doctor to ensure you’re on the right track. If you do become pregnant be sure to inform your HIV doctor immediately. This is a part of ensuring that both you and your child will be healthy.

Undetectable Equals Untransmittable

If you’re married to someone who is not suffering from HIV the possibility of conceiving without the fear of passing HIV was once a challenge and usually required the use of intrauterine insemination as well as fertility treatments.

Nowadays, HIV experts follow a notion that is known as “U=U,” which stands for “undetectable equals untransmittable.” In other words, in the event that you don’t have an undetectable amount of HIV that you will not transmit HIV via sexual contact.

An undetectable viral load indicates that there is only a tiny amount of HIV within the blood. The fact that you take your antiretroviral medication each day will make your HIV load indiscernible.

“This is really a breakthrough discovery and a wonderful, freeing advancement, knowing that people living with HIV can and should have healthy and enjoyable sex lives and family-building opportunities that they and all people deserve,” Hahn declares.

“We know that people living with HIV can absolutely have healthy pregnancies and children free of HIV without the use of any special technologies aside from staying on their HIV medicines,” Hahn continues. “The great news that I tell the patients I care for now is really quite different from what we were saying 10 years ago.”

U=U can also be used to transfer HIV from a woman who is pregnant to their child in the event that they have a constant undetectable viral level prior to conception at the time of pregnancy, through pregnancy, and after delivery, according to Judy Levison, MD, an instructor in Obstetrics and Gynecology in Baylor College of Medicine who is a specialist on HIV pregnant women and HIV. Under those conditions, “there have been zero cases of transmission to babies,” she says.

Expecting a baby with a partner

If you’re suffering from HIV and would like to have a baby your first task is to begin taking your antiretroviral medication on a regular basis and achieve an undetectable viral load. (You must be taking this medication to protect your health, and if you’re thinking of having a baby then you’re doing it to safeguard your child.) You should keep a low HIV load for about 3-6 months. Then you are able to have sex without the use of a condom without the risk of passing HIV with your lover, Levison says.

If you are suffering from HIV and are looking to make your partner pregnant by using the aid of your sperm then the recommendation is the same: take your medication and get an undetectable level of viral infection then proceed and try to get pregnant.

If you’re not affected by HIV However, your companion is, consult your physician whether preexposure prophylaxis ( PrEP) is an alternative. PrEP is a daily medication that reduces the chance of contracting HIV. PrEP is safe during pregnancy as well as nursing.

Planning for Pregnancy and Birth

Many HIV medicines are safe to use during pregnancy, and you are likely to use the medication during pregnancy. It is recommended to test your HIV levels regularly – each month or so to ensure that it is not detected. Sometimes, medicines work different during the pregnancy period, and your doctor may have to alter your medication or dosage when your viral count increases.

Birth and labor for women with HIV is similar as those who don’t have HIV, Hahn says. It is possible to have vaginal births provided that your viral count is lower than 1,000 at the time you’re ready to give birth. If your viral load is higher than 1,000, you’ll require an operation called a C-section to lower the risk of your baby being diagnosed with HIV at the time of birth.

After the birth, your baby should be given four weeks AZT drug, which guards against HIV. You’ll have to test them several times at birth, two months, 2 weeks and after 4 months old, Hahn says.

Breastfeeding is not traditionally advised for those living with HIV as it is the standard recommendation for the U.S., as it was since 1985.

Many parents would like to breastfeed their children, Levison states. A group of experts has provided advice to that the U.S. Department of Health and Human Services (HHS) on this. The panel has confirmed that breastfeeding shouldn’t be recommended for those who have HIV since the risk isn’t completely zero. The panel however recommended that if a doctor is treating an individual who has HIV who is willing to nurse, they must discuss to them regarding the potential risks and advantages.

“We can’t say U equals U for breastfeeding, but we can say the risk is very low [for people who have undetectable viral loads],” Levison states. When you are deciding to feed your baby, she advises that you should be on your medication, have your viral levels checked every two to three months, and get your child tested on a regular basis.

“We just have to say we cannot give you a 100% guarantee that you won’t transmit” HIV to your baby via breastmilk, Levison says. “And then they need to make the decision that’s right for them.”

More Ways to Have a Family

People with HIV are able to use any type of fertility treatment such as IVF (IVF) or freezing of eggs. The sperm used for fertility treatment is regularly “washed” before it’s used. The process is designed to remove HIV out of the semen.

Fertility clinics can also assist you start a family by methods such as donor insemination or gestational surrogates when needed.

There is also the option of adopting. It’s against the law that adoption organizations discriminate against those who have HIV in accordance with the Americans with Disabilities Act.