Pregnancy and Parenting
Today, with advances in HIV treatment and care, people living with HIV in Canada can have healthy, HIV-negative babies.
Pregnancy & What You Need to Know
As part of Ontario's pre-natal care, women are offered an HIV test. Testing early in pregnancy, and after any subsequent risk activities, can be helpful to ensure early diagnosis and effective treatment, which can substantially reduce the risk of transmitting HIV to the fetus and improve health outcomes. Sexually transmitted and blood borne infection (STBBI) testing can also be done at this time.
People living with HIV can have healthy pregnancies and deliver healthy HIV negative babies. This is also the case for cis and Trans women, 2-Spirited and Non-Binary Femme people.
The earlier you get tested, the better the treatment outcomes. Beginning HIV treatment before or early in pregnancy plays a big part in reducing the risk of transmitting HIV to the fetus. Evidenceopens in a new window shows that if you start your HIV treatment before pregnancy and maintain an undetectable viral load throughout your entire pregnancy, you will not transmit HIV to your baby during pregnancy or delivery.
Support is important. Speak to a doctor with experience in HIV care before or early in your pregnancy so they can support you in your HIV treatment and care. Talking to other women living with HIV who have been through this experience can be helpful too.
A NOTE ABOUT HORMONAL CONTRACEPTION
For HIV-positive women who are taking hormonal contraception, it is important to note that several HIV drugs interfere with the way some hormonal contraceptives work, and the contraceptive may not be as effective as usual. If possible, it is a good idea to consult with a doctor about what contraception will work best for you.
WHAI & GENDER INCLUSION
WHAI seeks to be informed by and amplify the experiences of those who face structural discrimination and exclusion, impacting HIV risk and the health outcomes of those living with HIV. As such, our work focuses on engagement with cis and Trans women, 2-Spirited and Non-Binary Femme people who are living with HIV, African, Caribbean and Black (ACB), Indigenous, or newcomers, who use drugs or substances, have experiences with violence and / or have been / are incarcerated. Within these communities, our work includes those who are pregnant or parenting, living with different abilities, and span from young adults to seniors.
Throughout our work we seek to remember the importance of prioritizing and centring communities of women who face disproportionate structural risk factors related to HIV, as well as being a reminder that gender is not binary, and the importance of thoughtfulness towards inclusivity for Trans, 2-Spirited, and Non-Binary femme people in WHAI work. In our work, we capitalize identities, except “cis." This is to remind us of the privilege and space afforded cis people, and to support the amplification of identities outside gender-binary constructions.
Infant Feeding
What You Need to Know
Breastfeeding (or chestfeeding) carries some risk of passing on HIV to the baby. Since there is some risk of transmission through breastfeeding, formula feeding is recommended in Canada wherever possible. Ontario has a free formula program for women living with HIV. Click here for more information.opens in a new window
For updated guidelines about infant feeding see, "Canadian Pediatric & Perinatal HIV/AIDS Research Group consensus recommendations for infant feeding in the HIV context (2022)."
It is important to note that recommendations in Canada are different than in other low resource countries where the risk of HIV transmission through breast or chest feeding may not be as great as the risks associated with a lack of access to formula and/or clean water. For more information about HIV transmission through breast/chest milk, click hereopens in a new window.
A NOTE ABOUT LANGUAGE
"Chestfeeding" is one of the terms used by Transmasculine and non-binary parents to refer to how they feed their children from their bodies. People have different comfort levels with language, and WHAI strives to find ways to be accessible and inclusive and to reflect the advancement of gender-inclusive language. People have different preferences, and these preferences can change depending on the context, situation, sense of safety, or personal identity.
HIV Disclosure & Children
Information for Parents Living with HIV
HIV-positive women have the choice to disclose their HIV status to their children as well as anyone in their children’s lives (schools, babysitters, friends, etc.) This can be a complicated decision, but there are helpful resources that provide support.
CENTRING WOMEN'S EXPERIENCES
“When I had my baby I saw posters everywhere about the importance of breastfeeding. All the messages at the doctor’s office told me I was a bad person if I didn’t breastfeed. Then I had my obstetrician telling me that I wasn’t allowed to breastfeed because of having HIV. People would sometimes even comment on the street if I was bottle feeding. They thought I was a negligent mother. Some of my friends and family who don’t know I have HIV would judge me for bottle feeding.”
— A woman living with HIV (from Women, HIV & Stigma: A Toolkit for Creating Welcoming Spaces)
RESOURCES
Transmission Through Breastfeeding FAQ
The OHTN's resource for breast and chest feeding.
Having a Baby
CATIE's resource on pregnancy and infant feeding for people living with HIV.
The Power of Undetectable
CATIE's resource on what you need to know about HIV treatment as prevention.
Know Your Rights: Disclosure in School and Daycare
The Canadian HIV/AIDS Legal Network resource on laws regarding HIV disclosure in school and daycare settings.
Know Your Rights: Disclosure, Privacy, and Parenting
The Canadian HIV/AIDS Legal Network's resource on laws regarding HIV disclosure, privacy, and parenting.