Preventing Perinatal Transmission of HIV After Birth
Key Points
- Perinatal transmission of HIV (also called mother-to-child transmission of HIV) is when HIV is passed from a person with HIV to their child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk).
- Antiretroviral therapy (ART) is the use of a combination of HIV medicines (antiretrovirals) to treat HIV infection. Babies born to people with HIV should receive ART as soon as possible after birth (preferably within 6 hours of delivery) to prevent perinatal transmission of HIV. HIV medicines protect babies from HIV that could have passed from mother to child during pregnancy or childbirth.
- HIV testing is recommended for all babies born to people with HIV at 14 to 21 days of life, at 1 to 2 months, and again at 4 to 6 months. Additional testing at birth and other time points is recommended for babies at higher risk of perinatal transmission of HIV. If testing shows that a baby has HIV, the baby receives ART.
- Although HIV can be transmitted through breastfeeding, taking HIV medicines and having an undetectable viral load during pregnancy and throughout breastfeeding lower the risk of passing HIV to less than 1%. Pregnant people with HIV should talk to their health care provider about options for feeding their baby.
After birth, do babies born to people with HIV receive HIV medicines to prevent perinatal transmission of HIV?
Antiretroviral therapy (ART) is the use of a combination of HIV medicines to treat HIV infection. After birth, all babies born to people with HIV should receive HIV medicines. This should be given as soon as possible after birth, preferably within 6 hours of delivery, to prevent perinatal transmission of HIV (also called mother-to-child transmission of HIV). HIV medicines given to babies after birth protect against HIV that could have passed from mother to child during pregnancy or childbirth. HIV medicines are called antiretrovirals.
What HIV medicines are given to babies after birth to prevent perinatal transmission of HIV?
The HIV medicine that a baby receives depends on the birthing parent’s viral load and other factors.
Babies at higher risk of perinatal transmission of HIV receive three HIV medicines for up to 6 weeks after birth. This includes babies born to people who are not virally suppressed near delivery.
How soon after birth are babies born to people with HIV tested for HIV?
HIV testing is recommended for all babies born to people with HIV at 14 to 21 days of life, at 1 to 2 months, and again at 4 to 6 months. Additional testing at birth and other time points is recommended for babies at higher risk of perinatal transmission of HIV. The HIV test (called a virologic test) looks for HIV in the blood.
If testing shows that a baby has HIV, the baby receives ART. ART helps people with HIV live long, healthy lives.
What other steps protect babies from HIV?
Pregnant people with HIV are encouraged to talk to their medical team about options for feeding their baby after birth. With consistent use of HIV medication and an undetectable viral load during pregnancy and throughout breastfeeding, the risk of transmission to a breastfed baby is low: less than 1%, but not zero. Alternatively, properly prepared formula and pasteurized donor human milk from a milk bank are options that eliminate the risk of transmission to a baby after birth. Pregnant people with HIV can speak with their health care provider to determine what method of feeding their baby is right for them.
Additionally, babies should not eat food that was pre-chewed by a person with HIV.
To learn more, read the HIVinfo fact sheets:
This fact sheet is based on information from the following sources:
From the Centers for Disease Control and Prevention (CDC):
From the Department of Health and Human Services:
- Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States:
- Infant Feeding for Individuals with HIV in the United States
- Management of Infants Born to People with HIV Infection: Antiretroviral Management of Newborns with Perinatal HIV Exposure or HIV Infection
- Management of Infants Born to People with HIV Infection: Diagnosis of HIV Infection in Infants and Children
- Management of Infants Born to People with HIV Infection: Initial Postnatal Management of the Neonate Exposed to HIV
Also see the HIV Source collection of HIV links and resources. For more information regarding infant feeding for people with HIV, see HIVE and the Well Project.