Q: Can two HIV-positive parents have an HIV-negative child?

Yes, they can. Although HIV can pass from an HIV-infected mother to her child during pregnancy, at the time of birth, or when breast-feeding the infant, medical treatment of both the mother and her infant can minimize the chances of that happening. HIV infection in both the mother and the biologic father does not appear to affect the likelihood of having an HIV-infected baby.

HIV-infected women ideally should start antiretroviral therapy (ART) before pregnancy, both for their own health and to reduce the risk of HIV transmission during pregnancy. Women already on ART should continue to receive it during pregnancy. The goal is to lower the mother’s HIV viral load (the concentration of HIV in her blood) as much as possible to prevent infection of the fetus. The lower the mother’s viral load during pregnancy and birth, the lower the risk of infecting her baby. A baby’s chances of being born with HIV are less than 2 in 100 when the mother has a viral load so low that it’s undetectable.

After delivery, the infant should receive ART for 6 weeks. In addition, the mother should avoid breast-feeding her baby to prevent transmitting the virus through her breast milk.The mother can breastfeed the baby while on cotrimoxazole therapy for a period of one year, then stop breast feeding after one year.

For their own peace of mind, HIV-infected couples wanting to have children should receive counseling, if possible, before making a decision about conception. During counseling sessions, they should ask about the likelihood that they will survive long enough to parent effectively. They should learn how to deal with the possibility that their infant may become HIV infected. And they should learn how to cope if members of their family or community judge and stigmatize them or their child.

Healthpostuganda@ronaldmutebi.

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