Your Guide To...BHIVA Standards of Care for People Living with HIV


5. Sexual and reproductive health

This Standard looks at how you can have a healthy sex life. It also looks at the issues around contraception, pregnancy, breastfeeding and the menopause.

Standard 5 - Sexual and reproductive health


5b. Reproductive health

You may wish to either plan pregnancies or avoid pregnancy.

If you wish to avoid pregnancy, you should be given advice on, and access to, the full range of contraceptive methods. Some types of contraceptive pill may interact with some HIV treatments. There are now many options for antiretroviral treatment (ART), so it should usually be possible to find one that works well with your preferred method of contraception.

If you are planning to have a baby, it is possible to conceive naturally. If the amount of virus in your blood is undetectable, then U=U, and there is zero risk of transmitting HIV to your partner, even when not using condoms. But, if you are not undetectable, then PrEPPrEP is ART that is used by people who are HIV negative to stop them getting HIV. At present, it usually involves taking drugs on a daily basis. PrEP is dramatically effective for HIV prevention. for your partner as protection against HIV may be considered.

Modern ART for pregnant women living with HIV has reduced the risk of HIV for newborn babies to almost zero. The most important things to consider for your baby to be healthy are your own health and your own HIV treatment. You should have full access to all the services and support you need during pregnancy, delivery, and after your baby is born, including peer support. Talking with other women who are living with HIV and who also have children can be very helpful.

You should be given information and support about options for feeding your baby. Formula milkformula milk, also known as baby formula or infant formula, is usually made from cows’ milk that has been treated to make it more suitable for babies. There’s a wide range of brands and types of formula available in pharmacies and shops. It comes in two different forms: a dry powder you make up with water, or a ready-to-feed liquid formula. Formula milk has zero risk of transmitting HIV to your baby. has zero risk of transmitting HIV to your baby. Breastfeeding, even if you are undetectable on ART, means your baby may be at a very low risk of HIV. If you want to use formula milkformula milk, also known as baby formula or infant formula, is usually made from cows’ milk that has been treated to make it more suitable for babies. There’s a wide range of brands and types of formula available in pharmacies and shops. It comes in two different forms: a dry powder you make up with water, or a ready-to-feed liquid formula. Formula milk has zero risk of transmitting HIV to your baby., but can’t afford it, it should be made available free of charge.

Pregnant women living with HIV can be more likely to experience poor emotional health. You can be at increased risk of postnatal depression. Assessing and treating poor mental health both during and after pregnancy should be part of your care.

There is some evidence that women living with HIV may experience the menopause earlier and more severely than women who are HIV negative. You should have access to support and treatment for the menopause at whatever age this happens. This may include menopause hormone therapy (MHT), previously known as hormone replacement therapy (HRT)hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces hormones that are at a lower level as you approach the menopause. HRT is now referred to as menopause hormone therapy (MHT). It should be made available to women living with HIV in the same way that it is for anyone else. It is usually provided through your GP, but expert advice from your HIV care team is needed to avoid any potential drug interaction with your ART.. This has been shown to help reduce the symptoms of menopause. It should be made available to women living with HIV in the same way that it is for anyone else. It is usually provided through your GP, but expert advice from your HIV care team is needed to avoid any potential drug interactionDrug interaction (sometimes drug–drug interaction, or DDI). You might not get the correct dose when drugs interact with each other. ARVs may interact with other drugs you might be taking. These other drugs might be prescribed from your GP, or other specialists, to treat other conditions. They could also be other drugs you might buy from a pharmacy or chemist. And they include supplements or recreational drugs. You might get an increased or reduced dose of any of the drugs involved. This means you might not get the correct dose of your ARV, which could lead to increased levels of virus in your blood. Or you might not get the right treatment for your other condition. So this can be very serious. You should check with your HIV doctor and GP if you’re planning to take any drug as well as your ARVs. with your ART.


Key messages

  • You should have access to expert advice and services for all aspects of reproductive health. This includes contraception and pregnancy planning. It should also include information about breastfeeding.

  • It’s now possible to conceive naturally with no risk to your partner. HIV-negative partners are at zero at risk because U=U (undetectable = untransmittable). If you are not undetectable, PrEPPrEP is ART that is used by people who are HIV negative to stop them getting HIV. At present, it usually involves taking drugs on a daily basis. PrEP is dramatically effective for HIV prevention. may be available for a HIV-negative partner.

  • You should be given information and support during the menopause. This could include access to menopause hormone therapy (MHT)hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces hormones that are at a lower level as you approach the menopause. HRT is now referred to as menopause hormone therapy (MHT). It should be made available to women living with HIV in the same way that it is for anyone else. It is usually provided through your GP, but expert advice from your HIV care team is needed to avoid any potential drug interaction with your ART., when appropriate.