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Having Children

Introduction

People living with HIV (PLHIV) can have healthy children without transmitting (giving HIV to another person) to their partner or baby. Transmission of HIV from mother to child is extremely rare in Australia.

By taking HIV medications and with the support of health workers:

  • Women living with HIV can get pregnant without transmitting to their partner
  • Women living with HIV can reduce the risk of transmission to their baby to almost zero (<1%)
  • Men living with HIV can have children without transmitting to their partner or baby

Preparing to Have a Baby

If you, your partner, or both, have HIV and are thinking about having children you should tell your HIV doctor that you would like to have a baby. They will talk with you about the safest way to get pregnant and have a HIV-negative baby. They will make sure your HIV
medications are safe for pregnancy and that you have the right support.

Sometimes pregnancies can be unplanned. If this happens, see your doctor as soon as possible so they can give you the help and information you need.

Fertility

HIV can affect your ability to become pregnant. If you do not become pregnant in the first year of trying, it is a good idea to talk with your HIV doctor. They can give you helpful advice or refer you to a fertility clinic.

An ‘undetectable viral load’ (UVL) means that the amount of HIV in your blood is so low that it cannot be transmitted. This does not mean HIV is completely removed from the body or you are cured. It means that the amount of virus remaining is so low, it cannot be passed on by having sex. Most people can have an UVL if they stay on their HIV medication as the doctor prescribes.

Having a Baby with a HIV Negative Partner

When one partner is living with HIV and the other is not, it is possible to become pregnant without transmission to the negative partner. If the HIV-positive partner takes their HIV medications and maintains an undetectable viral load, there is no risk of transmission.

Regular testing is important to ensure the viral load is undetectable. Before trying to get pregnant, both partners should be checked and treated for sexually transmitted infections.

The HIV-negative partner can also take HIV medication before and while they are trying to get pregnant to prevent infection. This treatment is known as PrEP (Pre-Exposure Prophylaxis) and is an additional option if the partner with HIV has a detectable viral load. Talk to your doctor about this if you want more information.

Timing of sex to coincide with ovulation (about 2 weeks before the period starts) can be discussed with a treating doctor to increase the chance of getting pregnant and reduce risk of transmission. This means having sex for a few days when the female partner is most fertile.

Having a Baby when both partners are living with HIV

When both partners are living with HIV, couples can still have a HIV-negative child. If both partners are on HIV medications and have an undetectable viral load, the risk of transmitting HIV to their baby is almost zero.

Transmission to a Baby

The risk of transmitting HIV to the baby is reduced to less than 1% if a woman living with HIV:

  • Remains on HIV treatment during pregnancy. The doctor will recommend how the baby will be delivered (C-section or natural birth) depending on the situation, e.g. the mother’s viral load
  • Does not breastfeed
  • Makes sure her baby is given HIV treatment after birth (usually 4-6 weeks)

If a man living with HIV has an undetectable viral load and remains on HIV treatment during his partner’s pregnancy there is no risk of transmission to his partner or the baby.

Breastfeeding

In Australia, it is not recommended that HIV positive mothers breastfeed their babies, even when taking HIV medications. While transmission through breast milk is low it is NOT zero. It is important to speak to your HIV doctor so you can make the best decision for you and your baby.

Conclusion

All people living with HIV and their partners have the right to choose when and how they want to have children, and should be treated with respect whatever they decide. They are entitled to all the information they need, and the support of health workers so they can make informed decisions.

Useful Contacts:

Pozhet (Heterosexual HIV Service)

Support, information, referrals and events for heterosexuals at risk of living with HIV
Phone: 1800 812 404
https://pozhet.org.au/
pozhet@pozhet.org.au

Multicultural HIV and Hepatitis Service

Information and support for individuals and communities from culturally diverse backgrounds
Phone: 1800 108 098
www.mhahs.org.au
info@mhahs.org.au

Positive Life NSW

A community-based organisation for people with HIV
Phone: 1800 245 677
https://www.positivelife.org.au
contact@positivelife.org.au

Sexual Health Info Link

Sexual Health nurses who answer questions about HIV and STIs confidentially
Phone: 1800 451 624
https://www.shil.nsw.gov.au/
seslhd-shilmail@health.nsw.gov.au

Local Sexual Health Clinic

Visit the website below to find your closest appropriate sexual health service
https://www.health.nsw.gov.au/sexualhealth/Pages/sexual-health-clinics.aspx

The Albion Centre

Provide testing, education and counselling for people living with HIV
Phone: (02) 9332 9600
http://thealbioncentre.org.au/
education@thealbioncentre.org.au

The Paediatric HIV Service at Sydney Children’s Hospital

Medical management, psycho-social support, research, consultation and education for children and families living with HIV
Phone: (02) 9382 1508
http://www.schn.health.nsw.gov.au/find-a-service/health-medical-services/immune-deficiency-and-hiv/sch

TIS National Translating and Interpreting Service

Provides access to phone and on-site interpreting services in over 150 languages
Phone: 13 14 50
https://www.tisnational.gov.au/
tis.prebook@homeaffairs.gov.au