By As the world calls for a more human, equitable HIV response under the #RethinkRebuildRise movement, this World AIDS Day is a reminder of how profoundly HIV intersects with one of life’s most vulnerable journeys, becoming a parent. For many South African families, HIV is not a barrier to parenthood but a reality to be navigated with the right care, accurate information and a healthcare system that puts people first.
According to Lizeth Kruger, Dis-Chem Baby City’s Clinic Executive, modern medicine has transformed what it means to live, conceive, give birth, and raise children while living with HIV. What is needed now, she says, is a mindset shift. Kruger shares five ways South Africans can rethink HIV through the eyes of parents and rebuild a more supportive system that allows families to rise.
HIV does not limit your ability to start or grow a family
With proper treatment and planning, parents living with HIV can safely conceive, give birth, and raise healthy children. Viral suppression through ART reduces the risk of mother-to-child transmission to below 1%, yet many still fear pregnancy due to outdated assumptions. Clinics play a crucial role by offering judgement-free counselling to help families plan pregnancies, understand their treatment pathways and make informed choices with confidence rather than fear. Most healthcare professionals are adequately trained on this.
Rebuild support systems around both parents, not only mothers
The HIV response has traditionally focused on mothers, but modern parenthood includes diverse family structures. Doctors and nurses increasingly support fathers, partners, and caregivers, whether HIV-positive or HIV-negative to understand how to protect themselves, support the mother and nurture the child. When both parents are empowered with information and care, families thrive and transmission risks drop dramatically.
Normalise conversations in homes and communities
Stigma remains one of the biggest barriers to seeking care, disclosing status, or adhering to treatment. Parents often avoid discussing HIV out of fear of judgement, yet open conversations, within couples, with extended family and even with older children strengthen trust and emotional wellbeing. Clinics can guide families on how to talk about HIV in ways that protect dignity and reinforce unity.
Place mental health at the centre of care
The emotional weight of living with HIV, especially during pregnancy or early parenthood, can be overwhelming. Anxiety, stigma, and fear of judgement may affect bonding, treatment adherence, and overall wellbeing. Integrating mental-health support into maternal care, through counselling, support groups and screening for depression helps ensure that families overcome these challenges.
Breastfeeding is safe and strongly encouraged with the right care
For mothers living with HIV, breastfeeding is both possible and safe when supported by consistent antiretroviral therapy and regular clinical monitoring.
Exclusive breastfeeding for the first six months remains the recommended approach, providing essential nutrition, strengthening immunity and supporting healthy development.
With the right guidance and ongoing support from clinic teams, pharmacists and doctors, HIV-positive mothers can breastfeed confidently, knowing that viral suppression significantly reduces the risk of transmission and gives their babies the best start in life.