HIV/ AIDS and Pregnancy: Overview of Transmission

HIV and Pregnancy Overview

If you have HIV/AIDS and find out you are pregnant or think you may be pregnant, you should let your health care provider know as soon as possible. Some HIV/AIDS medicines may harm your baby. Your health care provider may want you to take different medicines or change the doses.

It is also possible to give HIV to your baby. This is most likely to happen around the time you give birth. For this reason, treatment during this time is very important for protecting your baby from infection.

Your baby will also need to have treatment for at least the first six weeks of life. Regular testing will be needed to find out if your baby is infected.

What is HIV/AIDS?

HIV (Human Immunodeficiency Virus) is a virus that causes AIDS (Acquired Immunodeficiency Syndrome). A person may be “HIV positive” but not have AIDS. An HIV infected person may not develop AIDS for 10 years or longer. A person who is HIV positive can transmit the virus to others when infected blood, semen or vaginal fluids come in contact with broken skin or mucus membranes.

An AIDS infected person cannot fight off diseases as they would normally and are more susceptible to infections, certain cancers and other health problems that can be life-threatening or fatal.

Should women be tested for HIV during my pregnancy?

Absolutely. If you’re HIV positive, getting proper treatment can significantly reduce your risk of spreading the virus to your baby and is crucial to protect your own health.

The CDC, American College of Obstetricians and Gynecologists (ACOG), and many other organizations recommend that all pregnant women be tested for HIV as early as possible. If you’re not offered an HIV test at your first prenatal visit, ask for one.

If you’re at high risk for an HIV infection, you should be tested again in your third trimester. You’re at high risk for HIV if:

• You’re in a relationship with a new sexual partner.
• You don’t know the HIV status of your new sexual partner.
• You or your partner inject drugs.
• You exchange sex for money or drugs.
• Your partner is HIV positive.

Although it’s best for both you and your baby to begin treatment during pregnancy, getting treatment later is better than not being treated at all. If you haven’t been tested during pregnancy, or you’re at high risk but your status is unknown, your healthcare provider may recommend rapid HIV testing when you’re admitted to the hospital for labor and delivery.

Rapid HIV testing can rule out the condition within 30 minutes, though you’ll need another test to confirm the diagnosis if you get a positive result. If you’re found to be HIV positive, you can take immediate precautions to reduce the risk of transmitting HIV to your baby during childbirth.

Finally if you weren’t tested before delivery, your baby may be tested after birth because starting treatment within 12 hours of delivery lowers a newborn’s risk of becoming infected. Newborn testing is voluntary in most states but not all. In New York, for example, all newborns are tested for HIV antibodies.

Should women with HIV take HIV medicines during pregnancy?

Yes. All pregnant women with HIV should take HIV medicines during pregnancy to prevent mother-to-child transmission of HIV. The HIV medicines will also protect the women’s health.

HIV medicines work by preventing HIV from multiplying, which reduces the amount of HIV in the body (viral load). A low viral load during pregnancy reduces the chances that any HIV will pass from mother to child during pregnancy and childbirth. Having less HIV in the body also helps keep the mother-to-be healthy.

How is HIV transmitted from mother to baby?

If you are a pregnant woman living with HIV, HIV in your blood could pass into your baby’s body. This is most likely to occur in the last few weeks of pregnancy, during labour, or delivery. Breastfeeding your baby can also transmit HIV, because HIV is found in your breastmilk.

There is a 15-45% chance of passing HIV to your baby if neither of you take HIV treatment.

Are HIV medicines safe to use during pregnancy?

Most HIV medicines are safe to use during pregnancy. In general, HIV medicines don’t increase the risk of birth defects.

When recommending HIV medicines for pregnant women with HIV, health care providers carefully consider the benefits and risks of specific HIV medicines.

What Chances That My Baby Will Become HIV Positive?

A baby can become infected with HIV in the womb, during delivery or while breastfeeding. If the mother does not receive treatment, 25 percent of babies born to women with HIV will be infected by the virus. With treatment that percentage can be reduced to less than 2 percent, according to the March of Dimes.