HIV and Pregnancy

by Brian M. Williams

HIV and PregnancyThere are more than 1.2 million people in the United States estimated to be living with HIV/AIDS. What's more, 25 percent of them are undiagnosed and unaware of their HIV infection.

Approximately 25 percent of people living with HIV in the United States are women and most are of childbearing age. Every year, more than 6000 HIV-positive women in the United States give birth.1

HIV, the virus that causes AIDS, brings on symptoms that are mild at first or could be mistaken for the flu or a cold. Many HIV positive women don't realize they're infected.

Testing for HIV

Whether or not you suspect you're infected with HIV, the Center for Disease Control recommends that all pregnant women have an HIV test at their first prenatal visit.

If you don't choose to test early in your pregnancy, your healthcare provider might ask you if you'd like to be tested in the third trimester using a rapid HIV test. If you test positive, your baby will have the benefit of medications to prevent transmission during delivery.

Benefits of HIV Testing

A mother who knows that she's HIV-positive early in her pregnancy, has more time to work with her healthcare provider to figure out how to protect her health and prevent transmitting HIV to her child.

If an infected woman isn't treated, the risk of transmitting HIV during pregnancy, birth, or postpartum to her baby is 25 percent. If HIV is diagnosed early on, medication can be given to lower the risk to 2 percent or less. The woman can also take steps to prevent passing HIV to her partner.

The HIV Antibody Test

A blood sample taken during your prenatal visit is tested for HIV antibodies. The test doesn't hurt you or your baby. You should get results back in a few days.

Planning Starts Before Pregnancy

Have you been diagnosed as HIV-positive? According to the Women Living Positive1 survey, about half of the HIV-positive women haven't discussed how their treatment options could affect their pregnancy until after they've already become pregnant.

Be proactive and talk to your HIV specialist about your choices. Discuss your goals early on in your treatment. This way you can work with your healthcare provider to avoid changes and modifications to the program after you become pregnant.

Dawn Averitt Bridge, a prominent HIV/AIDS advocate, was 19 years old when she was diagnosed with HIV in 1988. She was given six month to live. Now she's the mom of two daughters, who are HIV negative. HIV-positive women can have children with a significantly reduced risk of mother-to-child transmission of HIV. It's possible through aggressive prenatal care, and good access to treatment.

HIV-Positive and Pregnant: Your Care Plan

Your prenatal plan will address the medical, psychological, social and practical challenges of pregnancy with HIV. Your pregnancy will most likely be coordinated between a healthcare provider and HIV specialist.

If You're Presently on Anti-HIV Medications

Providers suggest that you continue taking your anti-HIV medications until you talk to your own healthcare provider. Contact them right away if you are taking Sustiva (or Atripla, an anti-HIV medication that contains Sustiva).

During the first trimester of pregnancy, Sustiva alone or in Atripla, may cause birth defects that develop during the first few months of pregnancy. Your healthcare provider will discuss safe alternatives for these medications. After the first trimester, Sustiva or Atripla can be used safely.

Anti-HIV Medication During Pregnancy

Taking anti-HIV medications during pregnancy reduces the amount of HIV in an infected mother’s body. Having less HIV in the body reduces the risk of mother-to-child transmission of HIV.

Some anti-HIV medications pass through the placenta and help protect the baby from HIV infection. This is especially important during delivery when the baby may be exposed to HIV in the mother’s genital fluids or blood.

Anti-HIV medications are used at the following times to reduce the risk of mother-to-child transmission of HIV: