HIV and Pregnancy

HIV Medicines During Pregnancy and Childbirth

Last Reviewed: July 26, 2024

Key Points

  • All pregnant people with HIV should take HIV medicines throughout pregnancy for their own health, to prevent perinatal transmission of HIV to the baby, and to prevent HIV transmission to sexual partners. (HIV medicines are called antiretrovirals). Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child.
  • Most HIV medicines are safe to use during pregnancy. In general, HIV medicines do not increase the risk of birth defects.
  • Generally, pregnant people with HIV can use the same HIV treatment regimens recommended for non-pregnant adults—unless the risk of any known side effects to a pregnant person or their baby outweighs the benefits of a treatment regimen.
  • All pregnant people with HIV should start taking HIV medicines as soon as possible during pregnancy. In most cases, people who are already on an effective HIV treatment regimen when they become pregnant should continue using the same regimen throughout their pregnancies.
  • A scheduled cesarean delivery (sometimes called a C-section) to prevent perinatal transmission of HIV is recommended for people who have high or unknown viral loads near the time of delivery.

Should people with HIV take HIV medicines during pregnancy?

Yes, all pregnant people with HIV should take HIV medicines throughout pregnancy for three reasons: 1) their own health, 2) to prevent perinatal transmission of HIV to the baby, and 3) to prevent HIV transmission to sexual partners. Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child.

HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce the amount of HIV in the body (called the viral load). HIV medicines are also called antiretrovirals. The goal is to achieve an undetectable viral load which is attained when the level of HIV in the blood is too low to be detected by a viral load test. The risk of perinatal transmission of HIV during pregnancy and childbirth is lowest when a person with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep the pregnant person healthy.

Are HIV medicines safe to use during pregnancy?

Most HIV medicines are safe to use during pregnancy. In general, HIV medicines do not increase the risk of birth defects. When recommending HIV medicines to use during pregnancy, health care providers consider the benefits and risks of specific HIV medicines for pregnant people and their unborn babies.

When should pregnant people with HIV start taking HIV medicines?

All pregnant people with HIV should start taking HIV medicines as soon as possible during pregnancy. In most cases, people who are already on an effective HIV treatment regimen when they become pregnant should continue using the same regimen throughout their pregnancies.

What HIV medicines should pregnant people with HIV take?

The choice of an HIV treatment regimen to use during pregnancy depends on several factors, including a person’s current or past use of HIV medicines, other concurrent medical conditions, and the results of drug-resistance testing. In general, pregnant persons with HIV can use the same HIV treatment regimens recommended for non-pregnant adults—unless the risk of any known side effects to a pregnant person or the baby outweighs the benefits of a treatment regimen.

Sometimes a person’s HIV treatment regimen may change during pregnancy. Pregnant people and their health care providers should discuss whether any changes need to be made to an HIV treatment regimen during pregnancy.

Do people with HIV continue to take HIV medicines during childbirth?

Yes, a baby is exposed to any HIV in the pregnant person's blood and other fluids while passing through the birth canal. During childbirth, HIV medicines that pass from birthing parent to baby across the placenta prevent perinatal transmission of HIV, especially near delivery.

Pregnant people who are already taking HIV medicines when they go into labor should continue taking their HIV medicines on schedule as much as possible during childbirth.

Can a cesarean delivery reduce the risk of perinatal transmission of HIV?

Yes, a scheduled cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in pregnant people who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery. A cesarean delivery to reduce the risk of perinatal transmission of HIV is scheduled for the 38th week of pregnancy, 2 weeks before the normal expected due date. 

A scheduled C-section to reduce the risk of perinatal transmission of HIV is not routinely recommended for pregnant people who are taking HIV medicines and have a viral load of 1,000 copies/mL or less. Of course, regardless of their viral load, a person with HIV may have a C-section for other medical reasons.

With the help of their health care providers, pregnant people can decide which HIV medicines to use during childbirth and whether they should have a scheduled C-section to prevent perinatal transmission of HIV.

Do pregnant people with HIV continue to take HIV medicines after childbirth?

Prenatal care for pregnant people with HIV includes counseling on the benefits of continuing HIV medicines after childbirth. HIV medicines help people with HIV live long, healthy lives and reduce the risk of HIV transmission. Together with their health care providers, people with HIV make decisions about continuing or changing their HIV medicines after childbirth.

After birth, babies born to people with HIV receive HIV medicine to reduce the risk of perinatal transmission of HIV. Several factors determine what HIV medicine they receive and how long they receive the medicine.

To learn more, read the HIVinfo fact sheet on Preventing Perinatal Transmission of HIV After Birth.

This fact sheet is based on information from the following sources:

From the NIH Office of AIDS Research:

Also see the HIV Source collection of HIV links and resources.