HIV and Perinatal Transmission: Preventing Perinatal HIV Transmission

HIV can be passed to a baby during pregnancy, childbirth, and breast/chestfeeding. This is called perinatal transmission.
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If you are pregnant or planning to get pregnant, get tested for HIV as soon as possible. If you have HIV, the sooner you start treatment the better—for your health and your baby’s health, and to prevent transmitting HIV to your sex partner. If you don’t have HIV, but your partner does, ask your health care provider about medicine to prevent HIV, called pre-exposure prophylaxis (PrEP). You can also talk to your health care provider about timing sex without a condom to coincide with ovulation to reduce the chances of HIV transmission and increase the likelihood of getting pregnant.

The HHS Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission has published recommendations on perinatal HIV prevention and offer additional information for health care providers of people with HIV who wish to breast/chestfeed.

What You Can Do If You Are Pregnant and Have HIV
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Visit your health care provider regularly.

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Take HIV treatment as prescribed to stay healthy, protect your partner, and protect your baby.

HIV treatment reduces the amount of HIV in the body (viral load) to a very low level. This is called viral suppression or an undetectable viral load.*

Getting and keeping an undetectable viral load is the best thing you can do to stay healthy and prevent transmission to your baby.

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The risk of transmitting HIV to your baby can be 1% or less if you:

  • Take HIV treatment as prescribed throughout pregnancy and delivery.
  • Give HIV medicines to your baby for 2 to 6 weeks after birth.

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If your HIV viral load is not low enough, a cesarean delivery can help prevent HIV transmission.

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The only option that eliminates risk of postnatal transmission of HIV to the baby is infant formula or pasteurized donor human milk. The PROMISE Study showed that keeping an undetectable viral load through pregnancy, labor and delivery and breast/chestfeeding substantially reduces the risk of transmitting HIV through breast/chestfeeding to less than 1%.

If you have HIV, do not pre-chew food for your baby.

*Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood. An undetectable viral load means having a viral load so low that a test can’t detect it. The benefits of having an undetectable viral load also apply to people who stay virally suppressed.

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People who are pregnant or trying to get pregnant should encourage their partners to also get tested for HIV. If either partner has HIV, that partner should take HIV treatment as prescribed to stay healthy and prevent transmission.

For babies with HIV, starting treatment early is important because the virus can progress quickly in children. Providing HIV treatment early can help children with HIV live longer, healthier lives.

  1. CDC.  Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.
  2. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018.HIV Surveillance Supplemental Report 2020;25(2).
  3. Nesheim SR, FitzHarris LF, Lampe MA, et al. Reconsidering the number of women with HIV infection who give birth annually in the United States. Public Health Rep 2018;133(6):637-43. PubMed abstract.
  4. Little KM, Taylor AW, Borkowf CB, et al. Perinatal antiretroviral exposure and prevented mother-to-child HIV infections in the era of antiretroviral prophylaxis in the United States, 1994-2010. Pediatr Infect Dis J 2017;36(1):66-71. PubMed abstract.
  5. Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the Unites States.
  6. Townsend CL, Cortina-Borja M, Peckham CS, et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS 2008;22(8):973-81. PubMed abstract.
  7. CDC. Achievements in public health: reduction in perinatal transmission of HIV infection—United States, 1985–2005. MMWR 2006;55(21):592-7.
  8. Fleming PL, Lindegren ML, Byers R, et al. Estimated number of perinatal HIV infections, U.S., 2000. Poster presented at: XIV International AIDS Conference; July 7-12, 2002; Barcelona, Italy.
  9. Whitmore SK, Zhang X, Taylor AW, et al. Estimated number of infants born to HIV-infected women in the United States and five dependent areas, 2006. J Acquir Immune Defic Syndr 2011;57(3):218-22.
  10. Valverde E, Short W, Brady K, et al. HIV medical provider’s assessment of the reproductive plans of women receiving HIV care: medical monitoring project provider survey, 2009. Paper presented at: 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 17-20, 2011; Rome, Italy.
  11. Whitmore SW, Taylor AW, Espinoza L, et al. Correlates of mother-to-child HIV transmission in the United States and Puerto Rico.Pediatrics 2012;129(1):74-81.
  12. Taylor AW, Nesheim S, Whitmore S, et al. Estimated number and characteristics associated with perinatal HIV infections, 33 states, United States, 2003–2007. Paper presented at: 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. July 17-20, 2011; Rome, Italy.
  13. Branson B, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(RR-14):1-17.
  14. Barrow RY, Newman LM, Douglas JM Jr. Taking positive steps to address STD disparities for African American communities. Sex Transm Dis 2008;35(12 Suppl):S1-S3.
  15. Gaur AH, Dominguez KL, Kalish ML, et al. Practice of feeding premasticated food to infants: a potential risk factor for HIV transmission. Pediatrics 2009;124(2):658-66.
  16. Lampe MA, Smith DK, Anderson GJ, Edwards AE, Nesheim SR. Achieving safe conception in HIV-discordant couples: the potential role of oral preexposure prophylaxis (PrEP) in the United States. Am J Obstet Gynecol 2011;204(6):488.e1-8.
  17. Luzuriaga K, Tabak B, Garber M, et al. HIV type 1 (HIV-1) proviral reservoirs decay continuously under sustained virologic control in HIV-1–infected children who received early treatment. J Infect Dis 2014;210(10);1529-38.
  18. Nesheim SR, Wiener J, FitzHarris L, et al. Brief report: estimated incidence of perinatally acquired HIV infection in the United States, 1978–2013; J Acquir Immune Defic Syndr 2017;76:461-4.