Frequently asked questions about HIV pregnancy and reproductive health planning
In general, if you are already taking ART that is working, you can stay on those medications. But some medications should be switched. If you are going to try and get pregnant, or even if you are not preventing pregnancy, it is best to speak to someone you trust in your medical team about what ART is the right option for you.
In general, if you are taking ART you can also take birth control pills or other types of birth control (like getting an IUD). It is best to speak to someone you trust in your medical team about what ART is the right option for you.
If you are looking for pregnancy planning advice, your HIV care provider might be able to support you.
If not, there are HIV care providers and/or pregnancy care providers in most major cities in Canada who you could be referred to for pre-pregnancy counselling.
If there is no expert in your area, or you do not know of any experts in your area, please have your HIV care provider contact the Canadian HIV Pregnancy Planning Team at www.hivpregnancyplanning.com.
Folic acid is a supplementation that is recommended before and during pregnancy to help make sure the neural tube (which becomes the spine) develops properly. It can be started as soon as you start thinking about pregnancy, but you definitely should be on it at least 3 months before pregnancy. If there is a chance you might become pregnant, you should be taking folic acid. Starting folic acid before pregnancy is really important. The recommended dose is 0.4 – 1 mg per day. You can buy folic acid at a drug store without a prescription and is usually found behind the pharmacy counter. Prenatal vitamins also contain folic acid. Speak to a healthcare professional if you have specific questions about folic acid.
U=U stands for undetectable = untransmittable. It is the slogan that has taken shape based on the evidence that people with undetectable viral loads cannot sexually transmit HIV.
Yes. Studies have shown that people with viral loads of less than 1500/ml cannot pass the virus to their sexual partners because the virus is not in the body fluids. The most important aspect is that people with undetectable viral loads continue to take their medication and maintain a suppressed viral load. So as long as you have an undetectable viral load, for at least 3 but preferably 6 months, you #cantpassiton.
Read the full story“I am still looking for the right support in all of this. I would love to talk to women who have gone through this journey whose lives have followed a similar path as mine.”
PrEP is the use of anti-HIV medication (the same kind of medication people living with HIV take to fight the virus inside their body) that keeps HIV negative people from becoming infected. Specifically, the anti-HIV medication consists of two antiretroviral drugs in a combination pill known as Truvada® and is taken as one pill per day. PrEP stops HIV from taking hold and spreading throughout the body. When taken daily, PrEP is highly effective for preventing HIV. PrEP is much less effective when it is not taken consistently. The Canadian HIV Pregnancy Planning Guidelines do not routinely recommend PrEP when trying to conceive a pregnancy in a serodiscordant couple. As long as the person who is trying to conceive that is living with HIV has an undetectable viral load, the decision to use PrEP would be based on personal choice.
It does not need to be complicated. If either you or your partner are living with HIV and are taking effective HIV medication and have an undetectable viral load, you can go ahead and have sex without a condom. If you or your partner or both of you are taking effective HIV medication and your viral load is undetectable, you cannot transmit the virus sexually (remember U=U). The Canadian HIV Pregnancy Planning Guidelines (CHPPG) recommend avoiding condomless sex until the person(s) with HIV has had an undetectable viral load for at least 3 months, but preferably 6 months, with at least two viral load measurements at least one month apart below the limit of detection. You may also want to time the condomless sex with peak fertility (i.e. ovulation). For more information on timing ovulation see the FAQ below, "Do we have to time ovulation?".
If, however, you are in a sero-discordant relationship (i.e., one partner is positive, the other is negative) with a non supressed viral load, and still want to get pregnant, it is highly recommended that you use condoms and the partner with HIV work with their HIV care team to achieve an undetectable viral load before trying to have sex without a condom. If this is not possible, it is essential that the negative partner take something called pre-exposure prophylaxis (PrEP), which is one pill per day to prevent HIV. Speak to a healthcare professional if you have specific questions about conception options.
Read the full story“A few years later, my partner and I started talking about having a baby. We were faced with some negative reactions to our decision - even our friends and family didn’t agree with it. I had to deal with a lot of judgement.”
The reason for this is NOT to reduce the risk of HIV transmission by reducing the number of times you have sex without a condom. Instead, the CHPPG recommends timing condomless sex with peak fertility because that will increase the chances of conception (getting pregnant). The timing of sex has to be around the time of ovulation or else pregnancy will not happen.
There are a number of ways you can monitor when you are ovulating. We have created a great resource that you can easily download and print: Ovulation 101.
No. Timing ovulation is a personal choice, but it may increase your chance of conceiving. Some people find this stressful and just like the idea of ‘seeing what happens’. If that is what you prefer or believe in, you don’t need to time ovulation when you first start trying. Over time, it may be recommended if you have not conceived.
In individual cases, timing ovulation may be recommended. It is always best to speak to a healthcare provider about your plans to try and conceive before starting to make sure you can make an informed decision about things like whether or not to time ovulation.
As a single person living with HIV, you have options to become a parent. These include having a biological child by working with a fertility clinic or having a biological child with someone you choose to co-parent with even if you don’t want a romantic relationship with them, or raising a non-biological child, such as through adoption or fostering.
The good news is that there are plenty of options. Options that other GBTQ+ men and single men have used to become parents include:
Decisions around conception would be based on the preference of the co-parents and should be based on the viral load of the person living with HIV (if applicable as in cases of two men, an HIV-negative partner may decide to be the biological parent). Canada is recognized as a very inclusive country for multi-parented families. Based on Children’s Law Reform Act, up to 4 parents can be listed on a birth certificate if a pre-conception parentage agreement is in place. If you are considering co-parenting in this way, you may want to speak to a lawyer before trying to conceive.
The good news is that there are plenty of options. Common options that other LGBTQ+ women and single women have used to become parents include: