Key points
- If you have an undetectable viral load, and neither you or your partner have any STIs, sex without a condom is fine.
- If your viral load is detectable, your HIV-negative partner might benefit from taking PrEP (a medication which prevents HIV transmission).
- Some hepatitis C treatment isn’t suitable to take during pregnancy or when trying to conceive for both women and men.
- HIV can affect your fertility, meaning it's harder to get pregnant naturally. If you are not pregnant after six months of trying, talk to your doctor.
Many women living with HIV have given birth to babies without HIV. Discuss your options with your HIV clinic and other women with HIV as soon as you start thinking about having a baby. Mentor Mothers provide support during and after pregnancy. They are available at Positively UK and 4M.
If you have an undetectable viral load, and neither of you have any sexually transmitted infections (STIs), sex without a condom is fine. Your HIV clinic should offer you a sexual health screening, as it will be important to know that you and your partner are in good general health.
If you have a detectable viral load, it is important to discuss your options with your HIV clinic. The aim will be to reduce or remove the risk of transmission to your partner (during sex) and your baby. This may include your HIV-negative partner taking PrEP (a medication which prevents HIV transmission).
If your partner also has HIV and has a detectable viral load, it is important to discuss conception options with your clinic.
If you or your partner also have hepatitis C, talk to your HIV clinic. Some hepatitis C treatment isn’t suitable to take during pregnancy or even when trying to conceive for both women and men. But with newer hepatitis C treatment, most people can be cured of hepatitis C within 8 or 12 weeks.
Everyone planning a pregnancy – whether or not they have HIV – is advised to take a daily folic acid supplement whilst trying to conceive and for the first 12 weeks of pregnancy. Folic acid (vitamin B9) helps cells in the body to develop. It is difficult to get enough through diet alone. If you are taking the anti-HIV medication dolutegravir you will be advised to take a higher dose of folic acid (5mg). If you are taking a drug called cotrimoxazole (Septrin), you may need to take an increased dose if you are also taking folic acid.
Fertility
There’s some evidence that women with HIV find it harder to become pregnant. HIV can affect your body’s ability to produce the hormones oestrogen and progesterone. This can affect your fertility or lead to an early menopause, meaning you are unable to get pregnant naturally, particularly if your CD4 cell counts are low.
If you are not pregnant after six months of trying, talk to your doctor for advice.