Getting Pregnant and HIV

Submitted on Sep 11, 2023

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Interested in Having Children?

Are you living with HIV and interested in having children? Are you HIV-negative and interested in having children with a partner who is living with HIV? Then know that you are not alone. The majority of women living with HIV are of child-bearing age. Advances in HIV treatment have dramatically lowered the chances that a pregnant person will pass HIV on to their baby (known as perinatal transmission, mother-to-child transmission, or vertical transmission). The chances of passing HIV from a pregnant person to their baby can be lower than one in 100 when certain steps are taken (see below for more details).

These same advances have made it possible for people living with HIV to live longer, healthier lives. They have also made it possible to reduce to zero the chance of passing HIV to a partner when trying to have a child. The different choices for getting pregnant while reducing the chances of transmitting HIV are known as options for safer conception.

The chances of passing HIV from a pregnant person to their baby can be lower than one in 100 when certain steps are taken.

Given the number of effective options for safer conception, it is no surprise that women and men living with HIV are interested in having children. The Women Living Positive Survey found that many women living with HIV in the US considered family planning an important part of their HIV care.

Some of the major safer conception options include treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP). Studies have confirmed that, if your partner living with HIV has an undetectable viral load, there is no chance that you will acquire HIV from him or her during sex. In simple terms: Undetectable Equals Untransmittable. This is treatment acting as prevention. PrEP is for HIV-negative people and involves taking HIV drugs before being exposed to HIV to prevent the person from acquiring HIV.

Options for Safer Conception

There are several different options for reducing the chances of passing on HIV while trying to get pregnant. Safer conception options are a bit different depending on whether the members of the couple are seroconcordant (both people are living with HIV) or serodifferent (also known as serodiscordant, "mixed status couples" or "magnetic couples"). In serodifferent couples, one person is living with HIV while the other is not. Options for safer conception within heterosexual serodifferent couples are based on which member of the couple is living with HIV – the man or the woman.

Please click the links below to see safer conception options that best suit your situation. The information can help you weigh the risks and benefits of each option, understand what might be best for you, and prepare for discussions with your health care provider.

It is important to note that the risk of a baby having HIV is based only on the HIV status of the pregnant person. If you are living with HIV and interested in getting pregnant, please also see our fact sheet on Pregnancy and HIV, which provides important information about what to do before you become pregnant, care during pregnancy, labor and delivery, and preventing HIV transmission to your baby.

Finding a Provider and Building a Support Network

Finding the right health care provider who is supportive of your plan to get pregnant is a big first step!

Despite the number of people living with HIV who want to get pregnant, there is sometimes limited access to information, options, and therapies. Many health care providers are not discussing family planning with their patients who are living with HIV. Some do not have sufficient information to share, while others openly discourage people living with HIV from having children. In the US, some laws prevent access to fertility treatments for those living with HIV, and many insurance plans do not cover these procedures. Despite the challenges you may face when wanting to get pregnant, it is possible for people living with HIV to have children.

When choosing to have a child as a person living with HIV, it is important to be an advocate for yourself and your future child. Finding the right health care provider who is supportive of your plan to get pregnant is a big first step! A friendly health care provider can talk with you about many issues around pregnancy and having children: which conception option is right for you, and appropriate HIV treatments for you and/or your partner. They may also be able to speak with you about whether to disclose your HIV status to others (including other providers, your child's pediatrician, additional friends and family), and how to manage any stigma or fear you may experience around living with HIV and being pregnant.

When The Well Project's Founder, Dawn Averitt, asked providers about getting pregnant more than 15 years ago, she faced some very negative reactions before she found a wonderful provider who supported her desire to have children. While her original experience in getting pregnant and having two healthy HIV-negative daughters is discussed in the three articles listed below, Dawn has also posted a blog, which says in part:

My own children are now 11 and nearly 13, and in most urban settings, no one raises an eyebrow when they say "my mom has HIV." I wish I could say this was universal, but it isn't. Many health care providers are not familiar enough with the information about HIV to know that HIV-positive women can choose to become pregnant, and that, with access to good prenatal care and HIV treatment, their risk of transmitting HIV to their infants is less than two percent. This is why it is so important to find a health care provider who is knowledgeable about HIV and pregnancy – they are definitely out there! Dawn Averitt, Getting Pregnant while Living with HIV in 2015

For more information about Dawn's experience in trying to get pregnant, please explore the links below:

The Well Project has started a list of friendly family planning providers in the US who are informed about pregnancy planning for people living with HIV. Even though the providers listed might not be in your area, you may want to contact them for possible referrals or with questions you have. Pregnant women living with HIV and those seeking safer conception options can also contact Cynthia Gutierrez at HIVE, a renowned US-based family-building resource for HIV-affected people, at cynthia.gutierrez@ucsf.edu, for referrals to local providers.

Ultimately, you get to choose when and whether to have children.

Given the stigma against people living with HIV having children, you may encounter negative responses from others. Therefore, it is important that you build a strong support network of loving family, friends, and providers. Your support network can help you make good decisions and get through the negative, sometimes disheartening moments. If you do not have a good number of friends and family who support you, you may want to join a support group or consider starting your own group; for more information, see our fact sheet on Starting a Support Group.

Ultimately, you get to choose when and whether to have children. You deserve to be treated with respect and given access to the information necessary to make an informed decision and plan for your future.

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