Question

I am HIV positive and pregnant, what are the risks?

I am 32, married and have two children. I am HIV positive and so is my husband. I recently discovered I am pregnant but my husband is furious with me, and has advised me to go for an abortion. I am now debating on what to do as I do not want to go through a pregnancy without the support of my husband. What are the risks in pregnancy when HIV positive?

Answer

Thank you for your question.

Congratulations on the pregnancy and I am sorry if this is causing problems with your husband.

Is he upset because he is worried about the child becoming positive? Or because he is worried about your health? Or something else?

Also, are you already taking HIV treatment (ART)? this is because ART is good for both you and your baby’s health.

Many HIV positive women all over the world give birth to healthy negative children using ART. There is no medical reason stopping you from having this baby if you decide you want to continue with the pregnancy.

Also, for your health, HIV positive women are not usually at any further risk of pregnancy-related complications than negative women. As far as the HIV is concerned, most women have a small drop in their CD4 count of about 50, but this goes up again once the baby is born. For more information on this please follow this link.

For general information about HIV, Pregnancy and Women’s Health please  see this i-Base guide.

Good luck!

Note: this answer was updated in January 2018 from a question first posted in January 2011.

189 comments

  1. Lisa Thorley

    Hi Juliet.

    I’m sorry to hear that you’ve just been diagnosed. Are you able to talk to anyone and access support?
    I’m firstly going to answer your questions about pregnancy. At 20 weeks all women who are HIV+ and not on treatment are recommended to start treatment. It is being on ARVs that will reduce transmission. Is this something that you were told about when you were diagnosed?
    Though rare, some babies do contract HIV in utero. The risk of this is increased if you have a high viral load, and low CD4. Please see the following:

    http://i-base.info/guides/pregnancy/in-utero

    That said, most babies who are born to HIV+ mothers will be negative. The following guide has a lot of information about HIV and pregnancy. This includes treatment for you.

    http://i-base.info/guides/pregnancy

    As you also have HEP B, you will need to take a med that contains tenofovir and either FTC or 3TC. Meds containing this combination are available in Nigeria. If you are having problems with access, where may I ask do you live in Nigeria?

    With regards to your husband. I can’t tell you how to tell him. However, have you ever asked him his thoughts about HIV? Also, are you sure that he is negative?

  2. juliet

    I am almost 20week in pregnancy and I’ve just tested HIV and hepatitis B positive. But my husband is negative. I’m so scared to tell him. Is my baby at risk or infected already? I really don’t know how to go about having the treatment in my country Nigeria.

  3. Lisa Thorley

    Hi Sindiwa,

    With regards to your baby, as you are on treatment the risks of transmission are very low. Please see the following for more information about HIV and pregnancy:

    http://i-base.info/guides/pregnancy

    I can’t really tell you how to tell your partner. What I do know though, is that you are not the first person to be in this situation.

    I know it may be difficult, however there are many reasons why being HIV+ should not make any difference- especially because you are on treatment.

    Have you ever brought up HIV in conversation? You could try this.

  4. Sindiwa

    Hi,
    I have been positive for over 5 years and have been on treatment for 4 years now. I had a baby in 2009 before I was diagnosed and she is fine.
    I just found out that I am pregnant and my boyfriend doesn’t know that I am HIV positive. I know Im supposed to tell him but I couldn’t and still cant. Will the baby be fine? I don’t want him to know that I am positive. Please don’t judge me.

  5. Simon Collins

    Hi Nessie, if you are positive and on treatment, your husband’s status is not important. This is something he needs to find out about for himself by taking a test. Because your viral load is undetectable, you will not be putting him at any risk. You can also have more children in the future if you want to,

  6. nessie

    I tested hiv positive,two years ago I want t have a child my worry is that I don’t know the status of my husband. But I’m on treatment from 2 years and my viral load is undectable.im really worried that I can give birth to hiv positive child.advice please

  7. Simon Collins

    Hi Florence,, congratulations on your pregnancy. Being on treatment with an undetectable viral load is good for both you and the baby. Under these circumstances, the risk of transmission is less than 1 in 100 (less than 1%). good lcuk with everything.

  8. Florence

    Am HIV positive and have been on treatment for like 9 months and and my viral load is lower than detected . And it seems like am pregnant and wil I give birth to a health baby .

  9. Simon Collins

    Hi Shareen, from everything you said it is very unlikely that your baby has HIV. If the six week test was with viral load and you haven;t been breast feeding, then your baby doesn’t have HIV.

  10. Shareen

    Hi doc. I only found out that I am hiv positive @ 28 weeks. I started treatment same day. The following day I could not do anything,I had a heavy headache and was too dizzy so I missed a dose. From then I never missed a dose till I gave birth @ 38+4. I formular feed exclusively. My baby was not tested at birth but they tested her @ 6 weeks. The 6 weeks pcr results were negative. She is now 10 weeks and has oral thrush.could she be infected?

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