Sue from Adelaide writes: Dear Dr Louise, my partner and I would like to have children — how will HIV affect my pregnancy and my baby?
Thanks for writing, Sue. The question about having a baby enters many women’s minds at some time and if you are HIV-positive you may have concerns as to whether you can have a baby, what the risks are etc. In short — yes, you can give birth to a perfectly healthy bub!!!
Knowing your HIV status before you have a baby is a distinct advantage. This way you’ll receive specialist advice about conceiving, treatments and transmission risks. Regarding conception planning, if your partner is HIV-negative then timed intercourse when you are most fertile can be considered. The negative partner may also decide to take PrEP (pre-exposure prophylaxis). Your clinic can provide more information on this. Some couples choose to use self-insemination at the time of ovulation to further reduce the risk of transmitting the virus to their partner.
It’s important to be on treatment as HIV medications reduce the risk of transmission to the baby when the virus is fully suppressed. Without treatment, one in four babies born to HIV-positive mums will be HIV-positive themselves. This is known as vertical transmission and occurs near, or at the time of labour and delivery. As with sexual partners, the risk of transmitting HIV to your baby is greatly reduced when the viral load is undetectable (i.e. when you’re on effective treatment).
As well, it is recommended that all babies are given antiretroviral medications for some weeks after delivery to further reduce any risk of infection. This is standard management procedure and your obstetric team will discuss this with you.
It is important to be aware that HIV can be transmitted via breast milk. However, once again, this risk is significantly reduced when the viral load is undetectable — but it is not zero. In general, it is advised that HIV-positive women avoid breastfeeding and instead formula feed their babies. This is a discussion you can have with your healthcare providers.
So to wrap up: having a baby is something that is definitely possible for women living with HIV. Your doctor and treating team will be able to offer you information and assistance to ensure a safe outcome.