National Center for Training, Support, 
and Technical Assistance (NCTSTA) 

Let's Talk Pregnancy and HIV
So, what should we say to a client who wants to have a baby?
This toolkit provides an overview of the practical steps that nonclinical providers can take to help clients living with HIV, or whose partner is living with HIV, get pregnant safely, have a healthy pregnancy, and have a healthy baby.
Vertical transmission of HIV is when a mother living with HIV passes the virus to her fetus/infant during pregnancy, childbirth, or breastfeeding. In this resource we use the term "Vertical transmission" rather than "mother-to-child transmission" to communicate the importance of both the mother and father in preventing transmission of the virus to the baby.
   When advising clients:
  • Routinely recommend HIV testing for any client who either does not know his/her HIV status, or may have been at risk of acquiring HIV since his/her last test.
  • Assess pregnancy intentions. It's as simple as asking, "Do you or your partner plan to have a baby within the next year?"
  • Always recommend HIV testing for women trying to conceive and their partners.
  • Discuss how risk of vertical transmission can be reduced.
  • Offer couples counseling and testing where possible.
  • Link women who have HIV, or partners with HIV, to treatment care and support services.

--------  Before Conception  --------

Encourage and support your client and his/her partner to get tested for HIV as the first step.
Always offer HIV testing to men and women who want to start or expand their families. Pre-pregnancy testing is not just for women!
 Initiate the conversation about family planning and HIV testing with every client of reproductive age, whether male or female. 
                        HIV Testing                                              
Family Planning

HIV Testing &  Pregnancy Toolkit 

This toolkit is for providers. It includes links to posters, reference guides, and information on HIV test locations; it also includes client fact sheets and brochures.
Recommendations for HIV Prevention with Adults and Adolescents with HIV 
 This guide is for nonclinical providers. It covers important topics to discuss with couples wishing to establish a reproductive plan.  (see pg 42-44 ) .

Safe Conception and Access to Care
Do your clients have what they need to conceive safely  
and have a safe pregnancy?
  • Provide linkages to HIV care and treatment.
  • Ensure that the partner with HIV is in care, taking antiretroviral therapy, and has an undetectable viral load.
  • Discuss options for safe conception, particularly if the couple is discordant (one person is living with HIV and the other HIV-negative).
What Women Need to Know:
The HIV Treatment Guidelines
for Pregnant Women

This resource is for women living with HIV
who are pregnant or want to get pregnant. It provides an overview of the care and medicines that reduce risk
of vertical transmission. 
Thinking About Having a Baby?
A Resource for Women with Male Partners Who Are Living with HIV

This resource provides information
on safer conception for HIV negative women with male partners
who are living with HIV.
Home Insemination Guide:
A Guide for When Living with HIV

This guide provides information
for women living with HIV
who want to have children
with their HIV negative partners.  

This resource is for providers . It lists
key questions to assess clients' pregnancy intentions and
introduce preconception health.

 -------- During and After Pregnancy --------

During Pregnancy
  • Encourage your client to practice safer sex: a women's risk for HIV acquisition may double during pregnancy. If the mom-to-be is HIV-negative and her partner is HIV-positive, initiate a conversation about PrEP and its benefits for discordant couples.
  • Initiate a conversation about breastfeeding and other infant feeding options.
  • Encourage your client to continue with prenatal care and HIV treatment, if applicable.
  • Provide linkages to PrEP and other health and support services.
  • Discuss infant testing for HIV.
  • Continue to support safer infant feeding.
  • Encourage and provide support for your client(s) to stay in care.

Perinatal HIV/AIDS Management Advice Line (for service providers)
National Perinatal HIV Consultation and Referral Service
1 - 888 - 448 - 8765
Palm Cards


  Infant Feeding Basics For               
    Women Living with HIV                                                                     
One Test, Two Lives.
This resource is for women living with HIV. It summarizes current infant feeding recommendations in the context of HIV
PrEP during Pregnancy and/or while Breastfeeding 
This resource is for women who are HIV-negative but have partners who are living with HIV.  
This resource is for women living with HIV. It provide a summary of the steps to reduce risk of transmitting HIV to their fetus/infant.

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