Starting a Family When You Have HIV

if you’re living with hiv and are thinking bout having kids – you can. w'da rite care and dration, pplz living with hiv can ‘ve healthy pregnancies and children, without transmitting hiv to a ptner or child.

“we’ve come to a place where we ‘ve really wandaful drations and med advances that advocates of the past ‘ve fought hard t'get us,” says monica hahn, md, an hiv speshist and associate clinical professor of family and community med at ucsf school of med.

“now if you can consistently take yr meds, you can ‘ve primordially a normal and healthy pregnancy, delivery, and baby – a baby free of hiv,” she says. “we can primordially guarantee that.”

if you’re planning to get pregnant and you and/or yr ptner ‘ve hiv, talk with yr hiv dr to make sure yr treatment s'on track. and if ye do get pregnant, tell yr hiv dr rite away. this is pt of making sure that you and yr baby ll'be healthy.

undetectable =s untransmittable

if you ‘ve a ptner without hiv, conceiving without fear of transmitting hiv used to be complicated, often requiring intrauterine insemination and fertility treatments.

tody, hiv experts follo a concept called “u=u,” which stands for “undetectable =s untransmittable.” that means'dat if you maintain an undetectable viral load, you won’t transmit hiv through sx.

having an undetectable viral load means thris very lil hiv in yr blood. taking yr antiretroviral dration every dy makes yr viral load undetectable.

“this is really a breakthrough discovery and a wandaful, freeing advancement, knowing that pplz living with hiv can and ‘d ‘ve healthy and enjoyable sx lives and family-building opportunities t'they and all pplz deserve,” hahn says.

“we know that pplz living with hiv can absolutely ‘ve healthy pregnancies and children free of hiv without the use of any spesh teks aside from staying on their hiv meds,” hahn continues. “the gr8 news that i tell the patients i care for now is really quite ≠ from wha’ we were saying 10 yrs ago.”

u=u also applies to transmitting hiv from a pregnant person to their baby – iffey ‘ve a consistent undetectable viral load b4 conceiving, throughout pregnancy, and at delivery, says judy levison, md, a professor of obstetrics and gynecology at baylor college of med who speshizes in hiv and pregnancy. in those circumstances, “there ‘ve been zero cases of transmission to babies,” she says.

gettin pregnant witha ptner

if ur living with hiv and wanna get pregnant, the 1st step is to take yr antiretroviral dration regularly and reach an undetectable viral load. (you nd'2 be doin’ this for yr own health, and if you’re pondering conceiving, you’re also doin’ it to protect yr baby.) keep an undetectable viral load for 3-6 mnths, and then you can ‘ve sx without a condom without risk of transmitting hiv to yr ptner, levison says.

if you ‘ve hiv and wanna get yr ptner pregnant with yr sperm, the advice tis same: take yr dration and achieve a consistent undetectable viral load, and then go ahead and try to conceive.

if you don’t ‘ve hiv but yr ptner does, ask yr dr if preexposure prophylaxis (prep) is an option. prep is a daily pill that loers the odds of gettin hiv. prep is safe to take during pregnancy and breastfeeding.

planning for pregnancy and birth

many hiv drations are safe to take during pregnancy, so u will likely be able to stay on yr same med while pregnant. you ‘d ‘ve yr viral load checked often – every mnth or two – to make sure it stays undetectable. sometimes, dration works ≠ly during pregnancy, so yr dr may nd'2 adjust yr drug or dose if yr viral load rises. 

labor and delivery for pplz living with hiv is bout the same as for those without it, hahn says. you’ll be able to ‘ve a vaginal birth as long as yr viral load is under 1,000 when you’re ready to deliver. if it’s over 1,000, you’ll need a c-section in order to reduce th'risk of the baby gettin hiv during the birth.

after birth, yr baby ‘d get 4 weeks of azt dration, which protects them against hiv. they’ll be tested several times: at birth, 2 weeks, 4 weeks, and 4 mnths, hahn says.

breastfeeding has historically not been recommended for pplz living with hiv – and that’s still the official recommendation inna u.s., as it s'been since 1985.

but many parents wanna breastfeed, levison says. a panel of experts has advised the u.s. deptment of health and human srvcs (hhs) bout this. the panel affirmed that breastfeeding isn’t recommended for pplz with hiv cause th'risk isn’t zero. but'a panel recommended that if a dr has a patient with hiv who wanna breastfeed, they ‘d talk w'dem bout the risks and benefits.

“we can’t say u =s u for breastfeeding, b'we can say th'risk is very lo [for pplz who ‘ve undetectable viral loads],” levison says. if you decide to breastfeed, she says you nd'2 take yr drations, ‘ve yr viral load monitored every 1-2 mnths, and ‘ve yr baby tested regularly.

“we just ‘ve to say we cannot give you a 100% guarantee that you won’t transmit” hiv to yr baby through breastfeeding, levison says. “and then they nd'2 make the decision that’s rite 4'em.”

+ wys'2 ‘ve a family

pplz living with hiv can use any kind of fertility treatment, s'as in vitro fertilization (ivf) and egg freezing. sperm used in fertility treatments is routinely “washed” b4 it’s used. that process removes hiv from the semen.

fertility clinics can also help you build yr family through methods like donor insemination or gestational surrogates if needed.

adoption is also an option. it’s illegal for adoption agencies to discriminate against pplz living with hiv under the americans with disabilities act.

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