HIV and Pregnancy

Preventing Perinatal Transmission of HIV

  • Key Points

    • Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.
    • Women should get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.
    • The use of HIV medicines and other strategies have helped lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe. (HIV medicines are called antiretrovirals.)
    • Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. A scheduled cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in women who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery.
    • After birth, babies born to women with HIV should receive HIV medicines to reduce the risk of perinatal transmission of HIV. Several factors determine what HIV medicines babies receive and how long they receive the medicines.
    • Despite ongoing maternal use of HIV medicines after childbirth, a woman with HIV can still pass HIV to her baby while breastfeeding. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies.
  • What is perinatal transmission of HIV?

    Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.

    The use of HIV medicines and other strategies have helped to lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe. (HIV medicines are called antiretrovirals.)

  • Is HIV testing recommended for pregnant women?

    The Centers for Disease Control and Prevention (CDC) recommends that all women get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.

    All women who are pregnant or trying to get pregnant should encourage their partners also to get tested for HIV and, if possible, screened for other sexually transmitted diseases (STDs). STDs can increase viral loads in people with HIV. If any partner has HIV, that partner should take HIV medicine as prescribed to stay healthy and prevent transmission.

  • How do HIV medicines prevent perinatal transmission of HIV?

    Pregnant women with HIV should take HIV medicines to reduce the risk of perinatal transmission of HIV. When started early, HIV medicines can be more effective at preventing perinatal transmission of HIV. Women with HIV who are trying to conceive should start HIV medicines before they become pregnant to prevent perinatal transmission of HIV. Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. HIV medicines also protect the woman’s health.

    HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce the amount of HIV in the body (called the viral load). An undetectable viral load is 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 woman with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep the mother-to-be healthy.

    Some HIV medicines used during pregnancy that pass from the pregnant woman to her unborn baby through cesarean delivery  (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in women who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery.

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

  • 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. Health care providers discuss the benefits and risks of specific HIV medicines when helping women with HIV to decide which HIV medicines to use during pregnancy or while they are trying to conceive.

  • Are there other ways to prevent perinatal transmission of HIV?

    Despite ongoing maternal use of HIV medicines after childbirth, a woman with HIV can still pass HIV to her baby while breastfeeding. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies. Women with HIV can talk to their health care providers to discuss alternative options for feeding before their babies are born or even if they are already breastfeeding.

    Additionally, babies should not eat food that was pre-chewed by a person with HIV.

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

    From CDC:

    From the Department of Health and Human Services:

    Also see the HIV Source E-book for a collection of HIV links and resources.

HIV Medicines During Pregnancy and Childbirth

  • Key Points

    • All pregnant women with HIV should take HIV medicines throughout pregnancy for their own health and to prevent perinatal transmission of HIV. (HIV medicines are called antiretrovirals). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.
    • Most HIV medicines are safe to use during pregnancy. In general, HIV medicines do not increase the risk of birth defects.
    • Generally, pregnant women 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 woman or her baby outweighs the benefits of a treatment regimen.
    • All pregnant women with HIV should start taking HIV medicines as soon as possible during pregnancy. In most cases, women 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 women who have high or unknown viral loads near the time of delivery.
  • Should women with HIV take HIV medicines during pregnancy?

    Yes. All pregnant women with HIV should take HIV medicines throughout pregnancy for their own health and to prevent perinatal transmission of HIV. (HIV medicines are called antiretrovirals.) Perinatal transmission of HIV is also called mother-to-child transmission of HIV.

    HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce the amount of HIV in the body (called the viral load). An undetectable viral load is 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 woman with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep the mother-to-be 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 women and their unborn babies.

  • When should pregnant women with HIV start taking HIV medicines?

    All pregnant women with HIV should start taking HIV medicines as soon as possible during pregnancy. In most cases, women 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 a pregnant woman with HIV take?

    The choice of an HIV treatment regimen to use during pregnancy depends on several factors, including a woman’s current or past use of HIV medicines, other medical conditions she may have, and the results of drug-resistance testing. In general, pregnant women 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 woman or her baby outweighs the benefits of a treatment regimen.

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

  • Do women with HIV continue to take HIV medicines during childbirth?

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

    Women 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 women 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 a woman’s expected due date. 

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

    With the help of their health care providers, women 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 women with HIV continue to take HIV medicines after childbirth?

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

    After birth, babies born to women 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 Department of Health and Human Services:

    Also see the HIV Source E-book for a collection of HIV links and resources.

Preventing Perinatal Transmission of HIV

  • Key Points

    • Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.
    • Women should get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.
    • The use of HIV medicines and other strategies have helped lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe. (HIV medicines are called antiretrovirals.)
    • Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. A scheduled cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in women who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery.
    • After birth, babies born to women with HIV should receive HIV medicines to reduce the risk of perinatal transmission of HIV. Several factors determine what HIV medicines babies receive and how long they receive the medicines.
    • Despite ongoing maternal use of HIV medicines after childbirth, a woman with HIV can still pass HIV to her baby while breastfeeding. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies.
  • What is perinatal transmission of HIV?

    Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.

    The use of HIV medicines and other strategies have helped to lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe. (HIV medicines are called antiretrovirals.)

  • Is HIV testing recommended for pregnant women?

    The Centers for Disease Control and Prevention (CDC) recommends that all women get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.

    All women who are pregnant or trying to get pregnant should encourage their partners also to get tested for HIV and, if possible, screened for other sexually transmitted diseases (STDs). STDs can increase viral loads in people with HIV. If any partner has HIV, that partner should take HIV medicine as prescribed to stay healthy and prevent transmission.

  • How do HIV medicines prevent perinatal transmission of HIV?

    Pregnant women with HIV should take HIV medicines to reduce the risk of perinatal transmission of HIV. When started early, HIV medicines can be more effective at preventing perinatal transmission of HIV. Women with HIV who are trying to conceive should start HIV medicines before they become pregnant to prevent perinatal transmission of HIV. Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. HIV medicines also protect the woman’s health.

    HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce the amount of HIV in the body (called the viral load). An undetectable viral load is 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 woman with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep the mother-to-be healthy.

    Some HIV medicines used during pregnancy that pass from the pregnant woman to her unborn baby through cesarean delivery  (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in women who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery.

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

  • 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. Health care providers discuss the benefits and risks of specific HIV medicines when helping women with HIV to decide which HIV medicines to use during pregnancy or while they are trying to conceive.

  • Are there other ways to prevent perinatal transmission of HIV?

    Despite ongoing maternal use of HIV medicines after childbirth, a woman with HIV can still pass HIV to her baby while breastfeeding. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies. Women with HIV can talk to their health care providers to discuss alternative options for feeding before their babies are born or even if they are already breastfeeding.

    Additionally, babies should not eat food that was pre-chewed by a person with HIV.

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

    From CDC:

    From the Department of Health and Human Services:

    Also see the HIV Source E-book for a collection of HIV links and resources.

Preventing Perinatal Transmission of HIV After Birth

  • 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 also spread from a mother to her child through breast milk. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies.
  • 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?

    HIV can spread from a mother to her child through breast milk. In the United States, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies. Women with HIV can talk to their health care providers to discuss alternative options for feeding before their babies are born or even if they are already breastfeeding.

    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:

    Also see the HIV Source E-book for a collection of HIV links and resources.