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Starting a Family When You Have HIV


In the event you’re living with HIV and are fascinated with having children – you’ll be able to. With the proper care and drugs, folks dwelling with HIV can have wholesome pregnancies and kids, with out transmitting HIV to a associate or little one.

“We’ve come to a spot the place we’ve actually great medications and medical advances that advocates of the previous have fought laborious to get us,” says Monica Hahn, MD, an HIV specialist and affiliate medical professor of household and neighborhood drugs at UCSF College of Drugs.

“Now if you happen to can constantly take your medicines, you’ll be able to have primarily a traditional and wholesome being pregnant, supply, and baby – a child freed from HIV,” she says. “We will primarily assure that.”

In the event you’re planning to get pregnant and also you and/or your associate have HIV, discuss together with your HIV physician to verify your remedy is on observe. And if you happen to do get pregnant, inform your HIV physician immediately. That is a part of ensuring that you simply and your child might be wholesome.

Undetectable Equals Untransmittable

When you have a associate with out HIV, conceiving with out concern of transmitting HIV was sophisticated, typically requiring intrauterine insemination and fertility therapies.

Right now, HIV specialists comply with an idea referred to as “U=U,” which stands for “undetectable equals untransmittable.” That signifies that if you happen to preserve an undetectable viral load, you gained’t transmit HIV by means of intercourse.

Having an undetectable viral load means there may be little or no HIV in your blood. Taking your antiretroviral treatment daily makes your viral load undetectable.

“That is actually a breakthrough discovery and a beautiful, releasing development, realizing that individuals dwelling with HIV can and will have wholesome and pleasurable intercourse lives and family-building alternatives that they and all folks deserve,” Hahn says.

“We all know that individuals dwelling with HIV can completely have wholesome pregnancies and kids freed from HIV with out the usage of any particular applied sciences apart from staying on their HIV medicines,” Hahn continues. “The good information that I inform the sufferers I look after now’s actually fairly completely different from what we had been saying 10 years in the past.”

U=U additionally applies to transmitting HIV from a pregnant particular person to their baby – if they’ve a constant undetectable viral load earlier than conceiving, all through being pregnant, and at supply, says Judy Levison, MD, a professor of obstetrics and gynecology at Baylor School of Drugs who makes a speciality of HIV and being pregnant. In these circumstances, “there have been zero circumstances of transmission to infants,” she says.

Getting Pregnant with a Companion

If you’re dwelling with HIV and wish to get pregnant, step one is to take your antiretroviral treatment commonly and attain an undetectable viral load. (It’s essential be doing this to your personal well being, and if you happen to’re contemplating conceiving, you’re additionally doing it to guard your child.) Hold an undetectable viral load for 3-6 months, after which you’ll be able to have intercourse with out a condom with out danger of transmitting HIV to your associate, Levison says.

When you have HIV and wish to get your associate pregnant together with your sperm, the recommendation is identical: Take your treatment and obtain a constant undetectable viral load, after which go forward and attempt to conceive.

In the event you don’t have HIV however your associate does, ask your physician if preexposure prophylaxis (PrEP) is an possibility. PrEP is a every day capsule that lowers the chances of getting HIV. PrEP is secure to take throughout being pregnant and breastfeeding.

Planning for Being pregnant and Start

Many HIV drugs are secure to take throughout being pregnant, so you’ll probably be capable to keep in your similar drugs whereas pregnant. You must have your viral load checked typically – each month or two – to verify it stays undetectable. Typically, treatment works in another way throughout being pregnant, so your physician might have to regulate your drug or dose in case your viral load rises. 

Labor and delivery for folks dwelling with HIV is about the identical as for these with out it, Hahn says. You’ll be capable to have a vaginal start so long as your viral load is beneath 1,000 whenever you’re able to ship. If it’s over 1,000, you’ll want a C-section as a way to scale back the chance of the newborn getting HIV through the start.

After start, your child ought to get 4 weeks of AZT treatment, which protects them towards HIV. They’ll be examined a number of occasions: at start, 2 weeks, 4 weeks, and 4 months, Hahn says.

Breastfeeding has traditionally not been beneficial for folks dwelling with HIV – and that’s nonetheless the official suggestion within the U.S., because it has been since 1985.

However many dad and mom wish to breastfeed, Levison says. A panel of specialists has suggested the U.S. Division of Well being and Human Providers (HHS) about this. The panel affirmed that breastfeeding isn’t beneficial for folks with HIV as a result of the chance isn’t zero. However the panel beneficial that if a physician has a affected person with HIV who needs to breastfeed, they need to discuss with them concerning the dangers and advantages.

“We will’t say U equals U for breastfeeding, however we are able to say the chance may be very low [for people who have undetectable viral loads],” Levison says. In the event you determine to breastfeed, she says that you must take your drugs, have your viral load monitored each 1-2 months, and have your child examined commonly.

“We simply need to say we can’t offer you a 100% assure that you simply gained’t transmit” HIV to your child by means of breastfeeding, Levison says. “After which they should make the choice that’s proper for them.”

Extra Methods to Have a Household

Folks dwelling with HIV can use any sort of fertility remedy, comparable to in vitro fertilization (IVF) and egg freezing. Sperm utilized in fertility therapies is routinely “washed” earlier than it’s used. That course of removes HIV from the semen.

Fertility clinics may also enable you to construct your loved ones by means of strategies like donor insemination or gestational surrogates if wanted.

Adoption can also be an possibility. It’s unlawful for adoption businesses to discriminate towards folks dwelling with HIV beneath the People with Disabilities Act.

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