Explainer: Can people with HIV marry and have children?

HIV marry children
Image courtesy: HellasFrappe blogpost

The Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system of a person. HIV doesn’t cause death itself but over time, it weakens a person’s immune system to the extent that it is unable to fight against diseases, and eventually, the person can die. HIV causes Acquired Immune Deficiency Syndrome (AIDS).

Cases of HIV across world

There were 38.4 million people worldwide with HIV in 2021, rising from 30.8 million in 2010. Among the people living with HIV in 2021, 36.7 million were adults, and 1.7 million were children under age 15.

Rise of HIV in Pakistan

In Pakistan, the prevalence of HIV has risen at an alarming rate in recent decades, with a rising death toll. According to National Health Survey, Pakistan has an estimated 150,000 HIV patients, including 75,000 in Punjab, 15,000 in Khyber Pakhtunkhwa, and 5,000 in Balochistan.

While according to Pakistan’s National AIDS Control Program (NACP), over 165,000 persons in Pakistan are HIV positive, with just 24,331 (15%) being aware of their status. This number is continuing to rise. From 1987 to 2003, Pakistan was amid a low-prevalence pandemic. Although no study found substantial HIV in any group before 2002, this may have been owing to a lack of systematic surveillance systems.

Can HIV patients have children?

There is a common question: Can they have HIV-infected persons normal children? 

A diagnosis of HIV does not mean one can’t have children. But there is a risk of passing HIV to the baby during the pregnancy, while in labor while giving birth, or by breastfeeding. But, there are many ways, suggested by medical specialists, to lower the risk of passing HIV to your unborn baby to almost zero.

Many couples in which one person is HIV positive and the other person isn’t want to have children. According to doctors, it is possible to have a safe and successful pregnancy while preventing HIV from passing to the HIV-negative partner or the baby with careful planning. Some strategies reduce the likelihood of infection to near zero, though they are not proven to be 100% reliable. Transmission may occur in rare cases. 

When a person is taking HIV treatment, and they have an undetectable viral load, the risk of HIV being passed on to their baby is just 0.1% (or one in a thousand). On the other hand, when a person living with HIV has an undetectable viral load, there is no risk of HIV transmission during sex. 

If the mother is receiving treatment for HIV during pregnancy and doesn’t breastfeed her baby, it’s possible to greatly reduce the risk of the baby getting HIV.

All pregnant people living with HIV are advised by doctors to start taking medication by week 24 of pregnancy. 

The newborn baby will need to take anti-HIV drugs in liquid form for a specific period after birth. This does not mean that your baby has HIV.

The length of time, the newborn baby will need to take medication will depend on the viral load. If it is undetectable throughout pregnancy, the baby will be given medication for two weeks. If it is detectable, the medication may be extended to four weeks.

In the early years of the baby’s life, HIV tests will be done several times to detect the presence of HIV: just after birth; at six weeks; at 12 weeks; and at 18 months (final HIV antibody test).

If these tests are negative and the baby has never been breastfed, it will be known for sure that the baby does not have HIV.

HIV/AIDS in Pakistan: Confusion & denial | By Dr M Ahmed Abdullah