References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
People living with HIV in the UK can have healthy pregnancies and give birth to HIV-negative babies. With effective antiretroviral treatment and proper antenatal care, the risk of passing HIV to your baby is less than 1%. This guide covers what to expect at each stage and the steps that make the biggest difference.
If you’re thinking about pregnancy or have just found out you’re pregnant, talk to your HIV team as early as possible.
Order a discreet home HIV test
Before Pregnancy: Planning Ahead
- Talk to your HIV specialist about your plans
- Review your ART — some drugs are preferred in pregnancy, others are avoided
- Aim for an undetectable viral load before conceiving
- Check immunity to rubella, chickenpox and hepatitis B
- Start folic acid (400mcg daily) at least 3 months before trying
- Discuss your partner’s HIV status and testing
During Pregnancy
| Trimester | What Happens |
|---|---|
| First (weeks 1-12) | ART reviewed, baseline blood tests, dating scan |
| Second (weeks 13-27) | Regular viral load monitoring, anomaly scan, routine antenatal care |
| Third (weeks 28-40) | Viral load checked frequently, delivery plan discussed at 36 weeks |
You’ll have your usual NHS antenatal care plus extra appointments with your HIV team. Viral load is the key number — the aim is to be undetectable (below 50 copies/ml) by 36 weeks.
Delivery
Vaginal delivery is usually recommended. The risk of transmission during birth is extremely low.
A planned caesarean section at 38 weeks may be offered to reduce transmission risk.
After Birth
- Your baby will receive a short course of antiretroviral medication (usually 2-4 weeks)
- Blood tests at birth, 6 weeks, 12 weeks and 18 months check for HIV
- Most babies are confirmed HIV-negative by 3-4 months
Feeding Your Baby
In the UK, the NHS traditionally recommends formula feeding for mothers with HIV because it eliminates any risk of transmission through breastmilk. However, guidance is evolving — some UK clinics now support breastfeeding for women on effective ART with an undetectable viral load, with regular viral load monitoring. This should only be done with full clinical support and regular monitoring.
Your Rights
HIV-positive women have the same maternity rights as anyone else. You cannot be refused antenatal care because of your status, and your HIV diagnosis is confidential within your healthcare team.
Read more: Getting pregnant with HIV | What is HIV? | HIV and the immune system
Frequently Asked Questions
What is the risk of my baby getting HIV?
Less than 1% with effective treatment and proper care. Without treatment, the risk is 15-45%.
Can I breastfeed with HIV?
Formula feeding is the default recommendation in the UK. Some clinics now support breastfeeding with undetectable viral load and close monitoring, but only with full clinical support.
Will my HIV medication harm my baby?
Most modern HIV drugs are considered safe in pregnancy. Your specialist will choose a regimen with the best safety data for pregnancy.
Related reading
- Getting Pregnant When You Have HIV
- How STIs Affect Pregnancy and Breastfeeding
- Should I Be Tested for STIs During Pregnancy?
- STI Treatments During Pregnancy
- STIs and Pregnancy: What You Need to Know
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
