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Can HIV Positive People Safely Have Kids?

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People living with HIV and their partners can have healthy children that don’t have HIV. This is true whether it’s the sperm or egg of the person living with HIV, or they carry the pregnancy.

People living with HIV are sometimes called “HIV positive” and people who don’t have HIV are sometimes called “HIV negative”.

If you or a partner are HIV positive, it’s important to talk to your doctor about how to have a safe pregnancy. The most important thing for someone who’s HIV positive is to take their medication so that they have very little of the virus in their body.

One of the biggest risks for the baby is during childbirth. Doctors might recommend a C-section, a surgery where they take out the baby.

Will an HIV positive parent pass HIV to their child?

There’s a low risk that someone who’s regularly taking their HIV medications will pass HIV on to their baby. Most HIV medications are also safe to take during pregnancy. In North America, it’s rare for a child to get HIV from their parent.

For a baby to be born with HIV, the person who’s pregnant needs be HIV positive. Someone’s sperm can’t make a fetus HIV positive, unless it passes HIV to the person who gets pregnant.

A very small amount of HIV infections coming from the parents start before the baby is born. These are called congenital infections. The vast majority of HIV infections in babies happen either during childbirth or breastfeeding. This is because the virus can be passed to a baby through blood or breast milk. For this reason, doctors often recommend a cesarean delivery (also called a C-section) instead of a vaginal delivery when a parent is HIV positive.

What about after the baby is born?

After the baby is born from a positive parent, doctors typically give them medicine to lower their risk for HIV. Since breast milk can pass HIV, it’s usually recommended that HIV positive parents avoid breastfeeding. Baby formula is a safe and healthy alternative.

Doctors will also test the baby for HIV at different times after birth. If the baby is HIV positive, doctors will prescribe medications to make sure they stay healthy. With these, a baby can live a long, healthy life.

What should people with HIV do if they want to have kids?

If you or a partner is HIV positive, you may want to talk to your doctor before you try to get pregnant. In certain conditions, the risk is low enough that couples where a partner is HIV positive can safely get pregnant by having sex without a condom. This can mean:

  • making sure that an HIV positive partner takes their medication and has an undetectable viral load
  • no partner has any other STIs
  • partners only have sex without a condom on days when the person who can get pregnant is ovulating
  • an HIV negative partner can take a medication called PrEP (pre-exposure prophylaxis) to lower the chance of getting HIV even more
  • all partners get regular HIV testing

It’s especially important to lower the risk of passing HIV to the person who will get pregnant. This is because the baby can only get HIV from the person carrying the pregnancy. You can also talk to your doctor about other ways of getting pregnant. Sperm washing can take the HIV virus out of semen in a lab. Then, they can put the sperm into the vagina or uterus at the time of ovulation.

This option can be expensive, and health insurance doesn’t always cover it. You can also think about a sperm bank, adoption, or finding a surrogate to carry a pregnancy.

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