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HIV and Pregnancy

A mother living with HIV can transmit HIV to her baby during pregnancy, childbirth, or through breastfeeding.  However, there is hope. Women living with HIV can have healthy HIV-negative babies. Early diagnosis and treatment are critical. Consider the following:

You are at risk of HIV infection if you have unprotected sex, share injecting equipment, or circumstantially find yourself in a situation where the body fluids of another gain direct access to your bloodstream – even when pregnant.

Know your status!

It is recommended that you take a HIV test:

  • At your first antenatal appointment
  • During your third trimester
  • After delivery of your baby (in some settings)
  • As advised by your doctor

Your partner should also take an HIV test; benefits their health, your health and that of your new baby.  A HIV test can be administered at any time, even if you said ‘no’ before.

What if your partner receives a positive test for HIV or you already know they are living with HIV?

Although the risk of transmission for HIV will always remain, if your partner is adhering to medication and maintaining an undetectable status, the possibility of transmission lessens.

What if your HIV test returns negative/non-reactive results?

If you test negative for HIV, it is important to remain negative. If you have unprotected sex or share needles and syringes during your pregnancy, test again. You may also wish to ask your provider if PrEP or other alternative risk reduction treatments are right for you.

If you test positive for HIV and you are pregnant…

You can still give birth to HIV-negative babies. Seek advice about starting HIV treatment for your own health, and to protect your baby from HIV immediately. Current guidelines recommend starting HIV treatment (also called antiretroviral treatment or ART) as soon as you are diagnosed, and that you continue to take treatment for life.

If you already knew you were living with HIV, KEEP TAKING YOUR MEDIATION AND ADHERE TO PRESCRIBED TREATMENTS. Consult with your provider and with the Maternity & Infant Services Team at MAO. Your goal is to achieve an undetectable status.

You MUST take or continue your HIV treatment during pregnancy, labor and breastfeeding.

The birth of your child…

Your baby may be delivered naturally (vaginal delivery) or sometimes it is necessary to have a caesarian section which is considered a surgical procedure. Each requires a specific list of considerations. Consult with your provider about the best option for the delivery of your baby given your individual status.

A vaginal birth is usually recommended if there is a low level of HIV in your blood (an undetectable viral load).

A caesarean section is usually advised if there is a high level of HIV in your blood (a detectable viral load), or in an emergency.

Breastfeeding…

The best infant feeding option depends on the resources available to you and if you are taking treatment or not.

  • Baby formula feeding is the safest option. Plan to have access to formula, sterilization equipment and clean, boiled water every day.
  • If formula feeding is not an option, make sure to take continue your HIV treatments while breastfeeding.

HIV treatment for your baby.

If you are taking ART and you breastfeed, your baby should have 6 weeks of once-daily nevirapine (NVP).

If you formula feed, your baby should have 4-6 weeks of once-daily nevirapine (NVP) or twice-daily zidovudine (AZT).

Current guidelines recommend that your baby should have an HIV test at:

  • 4-6 weeks old (or as determined by your provider)
  • 18 months old or when breastfeeding finishes

If your baby tests HIV-positive, HIV treatment should be given to your baby as soon as possible.

Learn more by exploring the additional resources below:

HIV.gov

Medscape