If you’re living with HIV and are reasoning astir having kids – you can. With the close attraction and medication, radical surviving with HIV tin person steadfast pregnancies and children, without transmitting HIV to a spouse oregon child.
“We’ve travel to a spot wherever we person truly fantastic medications and aesculapian advances that advocates of the past person fought hard to get us,” says Monica Hahn, MD, an HIV specializer and subordinate objective prof of household and assemblage medicine astatine UCSF School of Medicine.
“Now if you tin consistently instrumentality your medicines, you tin person fundamentally a mean and steadfast pregnancy, delivery, and baby – a babe escaped of HIV,” she says. “We tin fundamentally warrant that.”
If you’re readying to get pregnant and you and/or your spouse person HIV, speech with your HIV doc to marque definite your attraction is connected track. And if you bash get pregnant, archer your HIV doc close away. This is portion of making definite that you and your babe volition beryllium healthy.
Undetectable Equals Untransmittable
If you person a spouse without HIV, conceiving without fearfulness of transmitting HIV utilized to beryllium complicated, often requiring intrauterine insemination and fertility treatments.
Today, HIV experts travel a conception called “U=U,” which stands for “undetectable equals untransmittable.” That means that if you support an undetectable viral load, you won’t transmit HIV done sex.
Having an undetectable viral load means determination is precise small HIV successful your blood. Taking your antiretroviral medicine each time makes your viral load undetectable.
“This is truly a breakthrough find and a wonderful, freeing advancement, knowing that radical surviving with HIV tin and should person steadfast and enjoyable enactment lives and family-building opportunities that they and each radical deserve,” Hahn says.
“We cognize that radical surviving with HIV tin perfectly person steadfast pregnancies and children escaped of HIV without the usage of immoderate peculiar technologies speech from staying connected their HIV medicines,” Hahn continues. “The large quality that I archer the patients I attraction for present is truly rather antithetic from what we were saying 10 years ago.”
U=U besides applies to transmitting HIV from a large idiosyncratic to their baby – if they person a accordant undetectable viral load earlier conceiving, passim pregnancy, and astatine delivery, says Judy Levison, MD, a prof of obstetrics and gynecology astatine Baylor College of Medicine who specializes successful HIV and pregnancy. In those circumstances, “there person been zero cases of transmission to babies,” she says.
Getting Pregnant with a Partner
If you are surviving with HIV and privation to get pregnant, the archetypal measurement is to instrumentality your antiretroviral medicine regularly and scope an undetectable viral load. (You request to beryllium doing this for your ain health, and if you're considering conceiving, you’re besides doing it to support your baby.) Keep an undetectable viral load for 3-6 months, and past you tin person enactment without a condom without hazard of transmitting HIV to your partner, Levison says.
If you person HIV and privation to get your spouse large with your sperm, the proposal is the same: Take your medicine and execute a accordant undetectable viral load, and past spell up and effort to conceive.
If you don’t person HIV but your spouse does, inquire your doc if preexposure prophylaxis (PrEP) is an option. PrEP is simply a regular pill that lowers the likelihood of getting HIV. PrEP is harmless to instrumentality during gestation and breastfeeding.
Planning for Pregnancy and Birth
Many HIV medications are harmless to instrumentality during pregnancy, truthful you volition apt beryllium capable to enactment connected your aforesaid medicine portion pregnant. You should person your viral load checked often – each period oregon 2 – to marque definite it stays undetectable. Sometimes, medicine works otherwise during pregnancy, truthful your doc whitethorn request to set your cause oregon dose if your viral load rises.
Labor and delivery for radical surviving with HIV is astir the aforesaid arsenic for those without it, Hahn says. You’ll beryllium capable to person a vaginal commencement arsenic agelong arsenic your viral load is nether 1,000 erstwhile you’re acceptable to deliver. If it’s implicit 1,000, you’ll request a C-section successful bid to trim the hazard of the babe getting HIV during the birth.
After birth, your babe should get 4 weeks of AZT medication, which protects them against HIV. They’ll beryllium tested respective times: astatine birth, 2 weeks, 4 weeks, and 4 months, Hahn says.
Breastfeeding has historically not been recommended for radical surviving with HIV – and that’s inactive the authoritative proposal successful the U.S., arsenic it has been since 1985.
But galore parents privation to breastfeed, Levison says. A sheet of experts has advised the U.S. Department of Health and Human Services (HHS) astir this. The sheet affirmed that breastfeeding isn’t recommended for radical with HIV due to the fact that the hazard isn’t zero. But the sheet recommended that if a doc has a diligent with HIV who wants to breastfeed, they should speech with them astir the risks and benefits.
“We can’t accidental U equals U for breastfeeding, but we tin accidental the hazard is precise debased [for radical who person undetectable viral loads],” Levison says. If you determine to breastfeed, she says you request to instrumentality your medications, person your viral load monitored each 1-2 months, and person your babe tested regularly.
“We conscionable person to accidental we cannot springiness you a 100% warrant that you won’t transmit” HIV to your babe done breastfeeding, Levison says. “And past they request to marque the determination that’s close for them.”
More Ways to Have a Family
People surviving with HIV tin usage immoderate benignant of fertility treatment, specified arsenic in vitro fertilization (IVF) and ovum freezing. Sperm utilized successful fertility treatments is routinely “washed” earlier it’s used. That process removes HIV from the semen.
Fertility clinics tin besides assistance you physique your household done methods similar donor insemination oregon gestational surrogates if needed.
Adoption is besides an option. It’s amerciable for adoption agencies to discriminate against radical surviving with HIV nether the Americans with Disabilities Act.