Starting a family if you have HIV

If you live with HIV and are thinking about having children, you can. With the right care and medication, people with HIV can have healthy pregnancies and children, without passing on HIV to their partner or child.

“We’ve come to a place where we have really great drugs and medical advances that past proponents have fought hard to get to us,” says Monica Hahn, MD, an HIV specialist and associate clinical professor of family and community medicine. at UCSF Faculty of Medicine.

“Now if you can consistently take your medications, you can essentially have a normal and healthy pregnancy, delivery, and baby — a baby without HIV,” she says. “We can essentially guarantee that.”

If you are planning to become pregnant and you and/or your partner have HIV, talk to your HIV doctor to make sure your treatment is on schedule. And if you do become pregnant, tell your HIV doctor right away. This is part of making sure you and your baby will be healthy.

Undetectable equals non-transferable

If you have a partner without HIV, getting pregnant without fear of HIV transmission used to be complicated, often requiring intrauterine insemination and fertility treatments.

Today, HIV experts follow a concept called “U=U,” which stands for “undetectable equals non-transmissible.” This means that if you maintain an undetectable viral load, you will not transmit HIV through sex.

If you have an undetectable viral load, there is very little HIV in your blood. If you take your antiretroviral medication every day, your viral load will be undetectable.

“This is truly a groundbreaking discovery and an amazing, liberating advance, 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 says.

“We know that people with HIV can have absolutely healthy pregnancies and children without HIV without the use of any special technologies, apart from their HIV medications,” continues Hahn. “The great news that I’m telling the patients I care for now is really very different from what we said 10 years ago.”

U=U also applies to passing HIV from a pregnant person to their baby — if they have a consistent undetectable viral load before becoming pregnant, during pregnancy, and during delivery, says Judy Levison, MD, professor obstetrics and gynecology at Baylor College of Medicine specializing in HIV and pregnancy. In those circumstances, “there have been zero cases of transmission to babies,” she says.