HIV and Pregnancy

Preventing Perinatal Transmission of HIV After Birth

Last Reviewed: January 31, 2023

This fact sheet is being revised to align with the recent updates to the Infant Feeding section of the Perinatal Guidelines.

Key Points

  • Babies born to women with HIV should receive HIV medicine (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 protect babies from HIV that could have passed from mother to child during pregnancy or childbirth. (HIV medicines are called antiretrovirals.)
  • HIV testing is recommended for all babies born to women 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 antiretroviral therapy (ART). ART is the daily use of a combination of HIV medicines to treat HIV infection. ART helps people with HIV live longer, healthier lives.
  • HIV can spread from a person with HIV to their child through breast milk. 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.

After birth, do babies born to women with HIV receive HIV medicines to prevent perinatal transmission of HIV?

After birth, all babies born to women 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 mother’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 women who are not virally suppressed near delivery.

How soon after birth are babies born to women with HIV tested for HIV?

HIV testing is recommended for all babies born to women 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 antiretroviral therapy (ART). ART is the daily use of a combination of HIV medicines to treat HIV infection. ART helps people with HIV live longer, healthier 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 Department of Health and Human Services:

Also see the HIV Source collection of HIV links and resources. For more information regarding breastfeeding and infant feeding, see HIVE and the Well Project.