Dr. Emily Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, conducted the medical review of this document. Living with the human immunodeficiency virus (HIV) and wanting to get pregnant can be overwhelming. You may wonder if you will transmit the virus to your baby or if you can continue taking your HIV medications while pregnant. These are valid concerns. However, many women living with HIV can have healthy babies. Each year, 3,500 individuals living with HIV in the United States give birth. Here are some reassuring answers to help you have conversations with your healthcare provider.
– Can I get pregnant if I have HIV? Yes, you can. It is ideal to talk to your HIV specialist before getting pregnant. This can help you be as healthy as possible before pregnancy, make medication adjustments, and prevent transmitting HIV to your baby. If you discover you are pregnant unexpectedly, notify your healthcare provider as soon as possible. While taking HIV medications and maintaining undetectable viral levels, the chances of transmitting HIV to your baby can be less than 1%. An undetectable viral load means that the level of HIV virus in your blood is so low it cannot be detected.
– Can I continue taking HIV medications during pregnancy? Yes, you can and should. Taking HIV medications during pregnancy is important to protect your health and your baby’s health. This significantly reduces the chances of HIV transmission to your baby. Do not skip doses and take your medications daily at the same time for the lowest possible viral load. Many HIV medications can be safely taken during pregnancy. However, depending on what you are taking and the stage of your pregnancy, your healthcare provider may suggest changing some of the HIV medications. It is important to discuss the advantages and disadvantages of potential medications with your healthcare provider.
– Are there risks for the baby if I have HIV? Most babies contract HIV during childbirth. If you have a vaginal delivery, your healthcare provider may provide medications through an IV line to reduce the chance of transmission. If your viral load is high, you may need to have a cesarean section and receive IV medications. This can reduce the risk of transmission. HIV can pass through the placenta and infect the baby in the womb. However, by following your HIV medication regimen during pregnancy, delivery, and postpartum, and providing your baby with HIV medications for two to six weeks after birth, your baby has less than a 1% chance of contracting HIV.
– Can I breastfeed if I have HIV? You can choose to breastfeed or use pumped milk with over a 99% chance of not transmitting HIV to your baby if you are taking HIV medications and have an undetectable viral load. Discuss the advantages and disadvantages with important family members and your HIV specialist to make the best decision for you and your baby.
– Can I take PrEP during pregnancy or while breastfeeding? You can safely take Pre-Exposure Prophylaxis (PrEP) during pregnancy or breastfeeding to prevent HIV transmission. It is safest to take PrEP as daily pills as PrEP injections are not approved for use during pregnancy.
Having HIV increases the risk of complications during pregnancy, such as miscarriages, stillbirths, and low birth weight babies, leading to more frequent medical consultations. Your healthcare team, including HIV specialists and obstetricians, will monitor you more closely to plan a healthy birth and prevent complications. They will conduct routine prenatal lab tests on your kidneys, liver, iron levels, blood sugar, and the effectiveness of HIV medications.
Progress has been made, and it is very possible for your baby to be born without HIV. Speak with your healthcare team to ensure the best possible health during your pregnancy while living with HIV. This educational resource was prepared with the support of Merck.
