HIV and Pregnancy

Preventing Perinatal Transmission of HIV

  • Key Points

    • People should get tested for HIV before they become pregnant or as early as possible during each pregnancy and during the third trimester. The earlier HIV is detected, the sooner HIV medicines (also known as antiretrovirals) can be started.
    • Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV was previously called mother-to-child transmission of HIV.
    • Pregnant people with HIV should take antiretroviral therapy (ART) throughout pregnancy and childbirth to prevent perinatal transmission of HIV. ART is the use of a combination of HIV medicines (antiretrovirals) to treat HIV. 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.
    • Most pregnant people with HIV can have vaginal deliveries.  If someone has a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery, a scheduled cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV.
    • After birth, babies born to people with HIV should receive HIV medicines to reduce the risk of perinatal transmission. Several factors determine what HIV medicines babies receive and how long they receive the medicines.
    • 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.

  • Is HIV testing recommended for pregnant people?

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

    All people 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 infections (STIs). STIs can increase the amount of HIV in the body (viral load) in people with HIV. If any partner has HIV, that partner should take HIV medicine as prescribed to stay healthy and prevent transmission.

  • What is perinatal transmission of HIV?

    Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). 

    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.)

  • How do HIV medicines prevent perinatal transmission of HIV?

    Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. Pregnant people with HIV should take HIV medicines to reduce the risk of perinatal transmission of HIV. The earlier HIV medicines are started, the more effective they are at preventing perinatal transmission of HIV. People with HIV who are trying to conceive should start HIV medicines before they become pregnant to prevent perinatal transmission. Pregnant and breastfeeding people with HIV should take HIV medicines throughout pregnancy, childbirth, and breastfeeding to prevent perinatal transmission. HIV medicines also protect the birthing parent’s health.

    HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce 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 person with HIV has an undetectable viral load. Having an undetectable viral load during pregnancy and throughout breastfeeding lowers the risk of perinatal transmission of HIV to less than 1%. Maintaining an undetectable viral load also helps keep the parent-to-be healthy.

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

  • Are HIV medicines safe to use during pregnancy?

    HIV medicines are safe to use during pregnancy. HIV medicines do not increase the risk of birth defects. Health care providers discuss the benefits and risks of specific HIV medicines when helping people with HIV decide which medicines to use during pregnancy or while they are trying to conceive. If an individual gets pregnant while on HIV medication, they should stay on that medication unless instructed to change by their health care provider.

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

    In people who have a high HIV viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery, a cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission.

    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 medicine 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.

  • 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. For more information regarding infant feeding for people with HIV, see HIVE and the Well Project.

HIV Medicines During Pregnancy and Childbirth

  • 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.

Preventing Perinatal Transmission of HIV

  • Key Points

    • People should get tested for HIV before they become pregnant or as early as possible during each pregnancy and during the third trimester. The earlier HIV is detected, the sooner HIV medicines (also known as antiretrovirals) can be started.
    • Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV was previously called mother-to-child transmission of HIV.
    • Pregnant people with HIV should take antiretroviral therapy (ART) throughout pregnancy and childbirth to prevent perinatal transmission of HIV. ART is the use of a combination of HIV medicines (antiretrovirals) to treat HIV. 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.
    • Most pregnant people with HIV can have vaginal deliveries.  If someone has a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery, a scheduled cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV.
    • After birth, babies born to people with HIV should receive HIV medicines to reduce the risk of perinatal transmission. Several factors determine what HIV medicines babies receive and how long they receive the medicines.
    • 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.

  • Is HIV testing recommended for pregnant people?

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

    All people 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 infections (STIs). STIs can increase the amount of HIV in the body (viral load) in people with HIV. If any partner has HIV, that partner should take HIV medicine as prescribed to stay healthy and prevent transmission.

  • What is perinatal transmission of HIV?

    Perinatal transmission of HIV means passing HIV from the mother or birthing parent to their child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). 

    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.)

  • How do HIV medicines prevent perinatal transmission of HIV?

    Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. Pregnant people with HIV should take HIV medicines to reduce the risk of perinatal transmission of HIV. The earlier HIV medicines are started, the more effective they are at preventing perinatal transmission of HIV. People with HIV who are trying to conceive should start HIV medicines before they become pregnant to prevent perinatal transmission. Pregnant and breastfeeding people with HIV should take HIV medicines throughout pregnancy, childbirth, and breastfeeding to prevent perinatal transmission. HIV medicines also protect the birthing parent’s health.

    HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce 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 person with HIV has an undetectable viral load. Having an undetectable viral load during pregnancy and throughout breastfeeding lowers the risk of perinatal transmission of HIV to less than 1%. Maintaining an undetectable viral load also helps keep the parent-to-be healthy.

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

  • Are HIV medicines safe to use during pregnancy?

    HIV medicines are safe to use during pregnancy. HIV medicines do not increase the risk of birth defects. Health care providers discuss the benefits and risks of specific HIV medicines when helping people with HIV decide which medicines to use during pregnancy or while they are trying to conceive. If an individual gets pregnant while on HIV medication, they should stay on that medication unless instructed to change by their health care provider.

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

    In people who have a high HIV viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery, a cesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission.

    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 medicine 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.

  • 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. For more information regarding infant feeding for people with HIV, see HIVE and the Well Project.

Preventing Perinatal Transmission of HIV After Birth

  • Key Points

    • Perinatal transmission of HIV means passing HIV from the mother or birthing parent 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 birthing parent 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 (transmitting HIV from the mother or birthing parent to the child). HIV medicines given to babies after birth protect against HIV that could have passed from birthing parent 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 NIH Office of AIDS Research:

    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.