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FAQ: Can two HIV-positive parents have an HIV-negative child?

for Veterans and the Public

Frequently Asked Questions

Q: Can two HIV-positive parents have an HIV-negative child?

Yes, they can. Although HIV can pass from a woman with HIV to her child during pregnancy, at the time of birth, or when breast-feeding the infant, medical treatment of both the mother and her infant can minimize the chances of that happening.

Q: When should couples with HIV seek counseling?

For their own peace of mind, couples with HIV wanting to have children should receive counseling before making a decision about conception. During counseling sessions, they should ask about ways to minimize the risk to the baby, and how to deal with the possibility of infection. If their health is frail, they should discuss the likelihood that they will survive long enough to parent effectively. And they should learn how to cope if members of their family or community judge and stigmatize them or their child.

Q: When should a woman planning to become pregnant start anti-retroviral therapy?

Women living with HIV ideally should start antiretroviral therapy (ART) before pregnancy, both for their own health and to reduce the risk of HIV transmission during pregnancy. Women already on ART should continue to receive it during pregnancy. The goal is to lower the mother's HIV viral load (the concentration of HIV in her blood) to "undetectable" levels to prevent infection of the fetus. The lower the mother's viral load during pregnancy and birth, the lower the risk of infecting her baby. A baby's chances of being born with HIV are about 0.4% when the mother has a viral load so low that it's undetectable.

Q: Should the new born child be treated?

After delivery, the infant should receive ART for at least 4-6 weeks. Longer durations of therapy are appropriate if the concentration of HIV in the mother's blood is not "undetectable" during pregnancy. In addition, the mother should avoid breastfeeding her baby to prevent transmitting the virus through her breast milk.

See related question: Can a couple in which one person is HIV-positive conceive a baby without the uninfected partner becoming infected?