Can HIV-positive couples have healthy children?

For couples where one or both partners are HIV-positive, concerns about passing the virus to their children can be overwhelming.

Fortunately, advancements in medical science have made it possible for HIV-positive couples to have healthy, HIV-negative children.

Here’s everything you need to know about how this works.

HIV (Human Immunodeficiency Virus) primarily spreads through unprotected sexual contact, sharing needles, or from mother to child during pregnancy, childbirth, or breastfeeding. The virus attacks the immune system, making it harder for the body to fight off infections and diseases. Without proper treatment, HIV can lead to AIDS (Acquired Immunodeficiency Syndrome), which is a life-threatening condition.

Thanks to medical advances, having HIV does not necessarily mean a child will be born with the virus. Antiretroviral therapy (ART), a treatment that reduces the amount of HIV in the body, prevents transmission.

When an HIV-positive person takes ART consistently and effectively, it can suppress the virus to undetectable levels, making it nearly impossible to transmit HIV to a partner or child.

1. Preconception care and planning: It is essential for HIV-positive couples to consult healthcare providers specialising in HIV before trying to conceive. This ensures that both partners are in good health, and that the HIV-positive partner’s viral load is undetectable. The healthcare provider can guide the safest ways to conceive and reduce the risk of transmission.

2. Effective use of ART: For HIV-positive mothers, taking ART throughout pregnancy, labour, and delivery is crucial. ART can lower the viral load to undetectable levels, reducing the risk of passing the virus to the baby to less than 1%. The use of ART during pregnancy is one of the most effective ways to ensure that the baby is born HIV-negative.

3. Special delivery methods: In some cases, healthcare providers may recommend a Cesarean section (C-section) to reduce the chance of transmission during delivery, especially if the viral load is not sufficiently controlled. However, if the mother’s viral load is undetectable, a natural delivery may still be safe.

4. Preventing postnatal transmission: After birth, the newborn may receive HIV medication for a few weeks as a precaution. Mothers are also advised to avoid breastfeeding if safe alternatives like formula feeding are available, as HIV can be transmitted through breast milk. In situations where breastfeeding is necessary, continuing ART while breastfeeding significantly lowers the transmission risk.