Starting a Family When You Have HIV

If you’re residing with HIV and are eager about having youngsters – you’ll be able to. With the fitting care and drugs, folks residing with HIV can have wholesome pregnancies and kids, with out transmitting HIV to a associate or little one.

“We’ve come to a place where we have really wonderful medications and medical advances that advocates of the past have fought hard to get us,” says Monica Hahn, MD, an HIV specialist and affiliate scientific professor of household and group medication at UCSF School of Medicine.

“Now if you can consistently take your medicines, you can have essentially a normal and healthy pregnancy, delivery, and baby – a baby free of HIV,” she says. “We can essentially guarantee that.”

If you’re planning to get pregnant and also you and/or your associate have HIV, discuss together with your HIV physician to ensure your remedy is on observe. And should you do get pregnant, inform your HIV physician immediately. This is a part of ensuring that you simply and your child will probably be wholesome.

Undetectable Equals Untransmittable

If you’ve a associate with out HIV, conceiving with out worry of transmitting HIV was difficult, typically requiring intrauterine insemination and fertility therapies.

Today, HIV consultants comply with an idea referred to as “U=U,” which stands for “undetectable equals untransmittable.” That signifies that should you preserve an undetectable viral load, you gained’t transmit HIV by means of intercourse.

Having an undetectable viral load means there may be little or no HIV in your blood. Taking your antiretroviral treatment day by day makes your viral load undetectable.

“This is really a breakthrough discovery and a wonderful, freeing advancement, 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 living with HIV can absolutely have healthy pregnancies and children free of HIV without the use of any special technologies aside from staying on their HIV medicines,” Hahn continues. “The great news that I tell the patients I care for now is really quite different from what we were saying 10 years ago.”

U=U additionally applies to transmitting HIV from a pregnant individual to their child – if they’ve a constant undetectable viral load earlier than conceiving, all through being pregnant, and at supply, says Judy Levison, MD, a professor of obstetrics and gynecology at Baylor College of Medicine who makes a speciality of HIV and being pregnant. In these circumstances, “there have been zero cases of transmission to babies,” she says.

Getting Pregnant with a Partner

If you might be residing with HIV and wish to get pregnant, step one is to take your antiretroviral treatment commonly and attain an undetectable viral load. (You must be doing this on your personal well being, and should you’re contemplating conceiving, you’re additionally doing it to guard your child.) Keep an undetectable viral load for 3-6 months, after which you’ll be able to have intercourse with no condom with out danger of transmitting HIV to your associate, Levison says.

If you’ve HIV and wish to get your associate pregnant together with your sperm, the recommendation is identical: Take your treatment and obtain a constant undetectable viral load, after which go forward and attempt to conceive.

If you don’t have HIV however your associate does, ask your physician if preexposure prophylaxis (PrEP) is an choice. PrEP is a each day capsule that lowers the percentages of getting HIV. PrEP is protected to take throughout being pregnant and breastfeeding.

Planning for Pregnancy and Birth

Many HIV medicines are protected to take throughout being pregnant, so you’ll seemingly be capable to keep in your identical medication whereas pregnant. You ought to have your viral load checked typically – each month or two – to ensure it stays undetectable. Sometimes, treatment works in a different way throughout being pregnant, so your physician may have to regulate your drug or dose in case your viral load rises. 

Labor and supply for folks residing with HIV is about the identical as for these with out it, Hahn says. You’ll be capable to have a vaginal delivery so long as your viral load is below 1,000 once you’re able to ship. If it’s over 1,000, you’ll want a C-section with the intention to scale back the chance of the infant getting HIV in the course of the delivery.

After delivery, your child ought to get 4 weeks of AZT treatment, which protects them in opposition to HIV. They’ll be examined a number of occasions: at delivery, 2 weeks, 4 weeks, and 4 months, Hahn says.

Breastfeeding has traditionally not been really helpful for folks residing with HIV – and that’s nonetheless the official suggestion within the U.S., because it has been since 1985.

But many dad and mom wish to breastfeed, Levison says. A panel of consultants has suggested the U.S. Department of Health and Human Services (HHS) about this. The panel affirmed that breastfeeding isn’t really helpful for folks with HIV as a result of the chance isn’t zero. But the panel really helpful that if a health care provider has a affected person with HIV who needs to breastfeed, they need to discuss with them in regards to the dangers and advantages.

“We can’t say U equals U for breastfeeding, but we can say the risk is very low [for people who have undetectable viral loads],” Levison says. If you resolve to breastfeed, she says it is advisable take your medicines, have your viral load monitored each 1-2 months, and have your child examined commonly.

“We just have to say we cannot give you a 100% guarantee that you won’t transmit” HIV to your child by means of breastfeeding, Levison says. “And then they need to make the decision that’s right for them.”

More Ways to Have a Family

People residing with HIV can use any form of fertility remedy, resembling in vitro fertilization (IVF) and egg freezing. Sperm utilized in fertility therapies is routinely “washed” earlier than it’s used. That course of removes HIV from the semen.

Fertility clinics also can assist you construct your loved ones by means of strategies like donor insemination or gestational surrogates if wanted.

Adoption can also be an choice. It’s unlawful for adoption companies to discriminate in opposition to folks residing with HIV below the Americans with Disabilities Act.