For the women who were in relationships with people who knew their status, their partners’ support played an important role in decisions about infant feeding. The information in this section comes from the experiences of two men, Edward and Stephen. Both men are HIV negative and were aware of their partners’ HIV diagnoses from the start of their relationships. Two of the women we spoke with had partners who were not aware of their HIV status and there were also some women whose partners did know, but they did not have in-depth conversations about infant feeding with them. Edward (Marella’s husband) and Stephen (Holly’s partner) therefore give a very specific perspective on being a partner of someone living with HIV.
If a person with HIV is taking their medication and has an undetectable viral load – meaning the virus is controlled – they cannot pass on HIV through sex. This is known as “U=U,” meaning Undetectable = Untransmittable. In this context, HIV cannot be passed on during sex, even when a condom is not used. Recent studies have found zero cases of HIV transmission through sex when a person has an undetectable viral load.
This page covers:
- How partners of women with HIV gained knowledge about HIV and infant feeding
- How partners of women with HIV contributed to and felt about decisions on infant feeding
How partners of women with HIV gained knowledge about HIV and infant feeding
Both Edward and Stephen received their information about HIV and infant feeding from medical staff and their partners. Their partners had gained knowledge and expertise about HIV and infant feeding through their own personal research and experiences. Edward felt fortunate that his wife Marella – who works within HIV care and support – helped him to understand the risks of HIV transmission and said about their decision to breastfeed that if “it wasn’t for her knowledge of it I think it would be a very different story”.
Most of Edward’s information came from his wife, but he also discussed infant feeding with doctors and midwives and was given a document with the latest guidelines (played by an actor).
Partners also received information during hospital appointments. Stephen didn’t attend every appointment, so Holly would relay important information to him afterwards. Edward thought it was important for hospital staff to initiate conversations about infant feeding early during pregnancy to allow couples more time to make an informed decision about what they wanted to do.
Edward felt that it was important for medical staff to share clear information about infant feeding early in pregnancy (played by an actor).
Stephen relied on information from sources he trusted, like his partner Holly, and the NHS website, to stay up to date about HIV and infant feeding choices. He also followed the news for stories about HIV.
Stephen found information about HIV and infant feeding from trusted sources like the NHS website.
How partners of women with HIV contributed to and felt about decisions on infant feeding
Edward and Stephen discussed the risks and benefits of breastfeeding and formula feeding with their partners during pregnancy. One of the important factors for them was the nutritional benefits of breastmilk.
Stephen, Holly’s partner, was interested in the benefits of breastfeeding for babies’ immune systems.
Edward and Marella have a two year old child, and Marella was pregnant. Their first child was born in the year that the UK guidelines changed to say breastfeeding can be supported if they meet certain criteria (e.g., undetectable viral load). Although Marella did meet the criteria, both she and Edward felt the change was too new to consider breastfeeding. Edward remembers that at the time of their first pregnancy there was a ‘lack of research and understanding of any potential risk’. He described being ‘shocked at the difference in the information that was being provided’. This time round, although it was the same information, more time had passed and they were looking at it with a different perspective.
Edward and his wife, Marella, have decided to breastfeed their second child, after formula feeding their first, because they are more confident about the low risk this time round (played by an actor).
Edward emphasised that his priority was ‘supporting my partner and the decision that she wants to make with it’. He thought it was important for partners to be on-board with the whole process of infant feeding, as well as the initial decision. Without the support of close family, he felt that breastfeeding was ‘far less likely to succeed’. He also recalled that he enjoyed formula feeding their older child.
Edward enjoyed being able to bond through formula feeding their first child, but is fully supportive of his wife’s decision to breastfeed their second child when the baby is born (played by an actor).
Stephen was initially keener on breastfeeding than his partner Holly, who was worried about the risks of passing on HIV. Stephen perceived the risk as very low because his partner has an undetectable viral load. He felt that ‘the advantages of breastfeeding for the first six months far outweigh the risk of passing, or a very, very low risk of passing HIV on’. After more discussion, and getting advice from health care professionals, his partner decided she would try breastfeeding.
Stephen’s partner, Holly, wasn’t sure about breastfeeding, but decided to try after receiving information about the benefits from midwives in their NCT class.
Although the UK guidelines advise that formula milk should be freely available to all mothers living with HIV, it is not available everywhere. In some parts of the UK, formula milk is freely available for women living with HIV through charities and clinics.