HIV and pregnancy and having children
People with HIV can plan to have children and become pregnant with a baby safe from the virus. With the right care today, the chance of a baby getting HIV from the mother has fallen to a very low level, and Thailand is a global example of success in preventing transmission from mother to child. This page brings together what is good to know — family planning for couples affected by HIV, testing and treatment during pregnancy, delivery, caring for the baby, and feeding — so that fathers, mothers, and babies can all be healthy and safe.
HIV and pregnancy and having children
HIV is not a barrier to having a family and children, with today's medical care.
You can have a baby safe from the virus
With the right care, people with HIV can have a baby without HIV, as the chance of transmission from mother to child has fallen to a very low level.
A dream that can come true
Both mothers and fathers with HIV can plan a family, and understanding the care involved helps make the journey to having a child confident and safe. See the treatment overview at HIV treatment: what you should know.
Thailand\u2019s success
Thailand is an outstanding example of success in preventing transmission from mother to child.
The first country in Asia
In 2016, Thailand was validated by the World Health Organization as the first country in Asia to eliminate transmission of HIV and syphilis from mother to child.
From high risk to very low
With a strong care system, Thailand reduced the rate of transmission from mother to child from as high as about 20 to 40 percent down to around 2 percent, showing that the right care truly works.
Hope for every family
This success means that families affected by HIV in Thailand can trust that a strong care system supports them, and having a baby safe from the virus is no longer out of reach.
Family planning for couples
Couples where one or both partners have HIV can plan to have children safely.
U=U allows conception with confidence
If the partner with HIV is treated to an undetectable viral load, they do not pass HIV on sexually, under U=U, so conceiving naturally carries a very low risk. Read the detail at what U=U is.
Options for added confidence
- the partner without HIV may use PrEP for extra protection
- planning the right timing for conception
- assisted reproductive technology in some cases
Consulting a doctor before pregnancy helps choose the approach that suits your couple.
It starts with a conversation
A good start is talking with a doctor about your wish to have children, and a doctor helps assess and plan what fits the health and situation of both partners, making the path to a child smoother.
HIV testing in antenatal care
HIV testing is a very important part of antenatal care.
Test from the start
Every pregnant woman should be tested for HIV from the first antenatal visit, and knowing your status early helps start care in time.
Knowing early means caring early
If the result is positive, starting treatment quickly greatly lowers the chance of passing HIV to the baby, so testing is the most important first step toward having a safe baby. Read about testing at HIV testing: the complete guide.
Antiretrovirals during pregnancy
Antiretroviral medicine is at the heart of preventing transmission from mother to child.
Take medicine throughout pregnancy
A pregnant woman with HIV should receive antiretrovirals and take them continuously throughout pregnancy, which controls the virus and protects both mother and baby.
Safe and recommended
Taking antiretrovirals during pregnancy is recommended and safe, and a doctor chooses a suitable regimen and monitors closely. Read about antiretrovirals at antiretroviral therapy.
The goal: an undetectable viral load
The goal of care during pregnancy is to control the virus to an undetectable level.
The lower the virus, the safer
When the mother's viral load is undetectable, the chance of the baby getting HIV is at its lowest, so taking medicine consistently to reach and keep this level matters a great deal.
Monitoring
A doctor checks the viral load from time to time during pregnancy, to make sure treatment is working and to plan the delivery appropriately.
An achievable goal
Controlling the virus to undetectable is a goal most people with HIV can reach by taking medicine consistently, and when reached, both the mother's health and the baby's safety improve together.
Delivery
Planning the delivery is part of the care that helps keep the baby safe.
The method depends on viral control
If the mother controls the virus well to undetectable, vaginal birth is usually possible. In some cases where the virus is not yet well controlled, a doctor may recommend a suitable delivery method to lower the risk.
Plan with a doctor
Talking with a doctor about the delivery plan in advance helps both mother and baby get the best care on the day of birth.
Prepare ahead
Preparing a delivery plan ahead of time with the health team reduces worry and makes the day of birth go smoothly, and the team looks after both mother and baby closely throughout.
Caring for the baby after birth
After birth, the baby receives special care for safety.
Preventive medicine for the baby
A baby born to a mother with HIV receives antiretroviral medicine for a period after birth as extra protection, as directed by a doctor.
Confirmatory testing
The baby is tested for HIV at the appropriate times to confirm their status. With this complete care, most babies are born safe from the virus.
Keep every appointment
Taking the baby for testing and medicine at every appointment is an important part of care, giving confidence in the baby's health status and ensuring continuous care.
Infant feeding
Infant feeding is something to plan with your health team.
Discuss the right approach
Choosing how to feed the baby should be done with a doctor and health team. In Thailand, replacement (formula) feeding is supported to reduce the chance of transmission through breastmilk.
Follow the advice consistently
Whichever method is chosen, following the health team's advice consistently helps keep the baby safest, and talking about this before birth helps you prepare well.
Support that is available
In Thailand there is support for feeding a baby, such as replacement formula, to help families care for their child safely, and asking the health team helps you access the support available.
Caring for the mother\u2019s health
Looking after the mother's own health matters just as much as caring for the baby.
Continue treatment after birth
After birth, a mother with HIV should keep taking antiretrovirals for her own health, and continuing treatment helps her stay healthy and care for her baby fully.
Care for body and mind
The period after birth can bring physical and emotional changes, and having a health team and supportive people helps a mother get through it well. Read about caring for your mind at mental health and nutrition when living with HIV.
In summary
People with HIV can have a baby safe from the virus with the right care. Thailand was the first country in Asia to eliminate transmission from mother to child, showing that good care truly works.
The key is testing for HIV from the start, taking antiretrovirals throughout pregnancy to keep the virus undetectable, planning the delivery, caring for the baby after birth, and planning feeding with the health team. Couples affected by HIV can also plan to have children safely, through U=U and consulting a doctor.
If you want to test for HIV, start treatment, or talk about planning a family, find and book a clinic at Love2Test.
References
Based on guidance from international and national health authorities.