There are a lot of women who have HIV and who are ready to have children. The treatment advancements for HIV have lowered the risk of HIV being passed on to the baby, which is called vertical, perinatal or mother to mother transmission. There is a chance that the mother can pass HIV to the infant which his about 1 in 100, whenever there are certain steps that are taken.
It is these same types of advances that have made it for people who have HIV to live much longer and even healthier lives. It has also provided a chance for there be a lower risk of transmitting HIV to a partner whenever trying to have a child. There are various choices for getting pregnant while still lowering the chances of transmission. These options are called safer conception.
There are many effective safer conception options, and it is not a surprise that men and women who have HIV are starting to want to have families. Based on a study from 2009, almost 7 out of 10 women who have HIV between the ages of 18 and 52 in Canada wanted to give birth. Another survey by Women Living Positive found that the same was for women who are HIV positive and living in the United States, and considered family planning to be a big part of their HIV care.
There are some big safer conception options which include the pre-exposure prophylaxis, also called PrEP and treatment as prevention, also called TasP. A study called HPTN 052, which was done in 2011 managed to show that HIV treatment could reduce the chances of someone who has HIV from giving HIV to another during sexual contact. There are many more studies that have confirmed that if your partner has HIV but has an undetectable viral load, then there not a chance that you will get HIV from having sex with them. Basically, Undetectable means that its not transmittable. PrEP is for people who are HIV negative and this means that they will have to take a HIV treatment before they get exposed to HIV in order to prevent them from getting HIV.
There are a few options for being able to reduce the chances of giving someone HIV while trying for a baby. The options for Safer conception are going to be different based on if you and your partner are seroconcordant, meaning that you are both HIV positive, or if you are serodifferent, meaning that one of you are HIV positive, while the other person is not. These couples are also called magnetic couples, serodiscordant, or mixed status couples. The safer conception options within a heterosexual serodifferent couple will be based on which person has HIV.
It is important that you take time and remember that the risk of your baby having HIV is based only on the HIV status of the mother. If you are a woman and you have HIV, and are interested in getting pregnant, then please do research and check out this fact sheet on HIV and Pregnancy, which will give you plenty of information about what you should do before you decide to get pregnant, your care during pregnancy, labor and delivery and how you can prevent transmitting HIV to your baby.
Even though there are a lot of people who have HIV who are wanting to have a baby, there can be limited access to options, information and even therapies. There are a lot of health care professionals who do not talk about family planning with people who have HIV. Some just do not have enough information to share, while others openly tell people who have HIV that is not best if they have children. In the United States, there are some laws that will prevent access to fertility treatments for those who have HIV, and a lot of insurances will not cover these procedures. Even though there are a lot of challenges you can face when you get pregnant, it is very possible for a person who is HIV positive to have children.
When a person is HIV positive and are deciding to have children, it is very important that you advocate for your future child and yourself. Locating the right type of health care provider who will be supportive of your plans to get pregnant will be the first step. A great health provider will talk to you about the issues that will come with your pregnancy, and having children as well as what type of conception option is going to be right for you and the treatments for HIV that you and/or your partner may need. These professionals may also speak to you about disclosing your status to others such as other health providers, additional family and friends and your pediatrician of your child. They can also help to manage the fear or stigma that you have around being pregnant and being HIV positive.
Dawn Averitt, the founder of The Well Project, had asked providers about becoming pregnant over 15 years ago, there were a lot of negative reactions before she was able to find a doctor who supported her desire to become a mother. While the original experience that she had in being pregnant and having 2 healthy babies that are both HIV negative has been discussed at length, Dawn also has a blog that talks about being pregnant and having HIV.
She stated that her children in their teens and being in an urban environment, when someone says that someone has aids, it isn’t a big deal. However, this is not universal. Most health care professionals are not familiar with all the information about HIV to know that women who have HIV can choose to have a baby, and that as long as there is access to great prenatal care and HIV treatments, then the risk of the baby getting HIV is less than 2%. That is why it is very important to find a doctor who will know about pregnancy and HIV.
There are a lot of providers who are willing to help anyone who is HIV to have children within the United States and are well informed about pregnancy planning for people with HIV. Even though some providers may not be in your area, you can contact them for referrals or with any questions that you may have. HIV positive pregnant women and those who are looking for safer conception options can contact HIVE, which is a resource for HIV affected people who want to have a family.
Ultimately it will be up to you if you decide to have a family. You deserve to be treated with respect and given access to any information need to make the best choice for you and to help you plan your future.
Written by Mark Riegel, MD
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