What Do I Need To Know About HIV During Pregnancy?

Question: What Do I Need To Know About HIV During Pregnancy?

Answer:

How Common is It?
The CDC estimates that in 2000, between 300 and 400 infants were born with HIV. This is a huge reduction from the nearly 2000 HIV+ infants born each year in the mid 1990s.

How is it Transmitted?
Doctors believe that most perinatal HIV transmission takes place around the time of birth, although infection can occur earlier during pregnancy. Anti-retroviral therapy during pregnancy and delivery greatly reduces the risk of transmission to the infant. HIV can also be transmitted through breast milk, so HIV+ women are generally instructed not to breastfeed. Cesarean section may be recommended for women with high viral load to reduce the risk of transmission during delivery.

Effect on Pregnancy Outcome:
The biggest concern for an HIV+ pregnant is whether or not her infant will also be infected. HIV does not otherwise affect pregnancy outcome.

Screening Recommendation:
All pregnant women should be screened during their first trimester. High-risk women should be screened again during their third trimester, and women who were never tested should have a rapid test at the time of delivery.

Treatment:
Women should be treated during pregnancy to reduce their viral load and lower the risk of transmission to the fetus. Sometimes treatment of the infant is recommended as well.

If a woman is already being treated for HIV she should speak to her physician before becoming pregnant, or once she knows she is pregnant, because some HIV drugs are safer during pregnancy than others. However, women should be treated during pregnancy. The risk of transmission to the infant is 25% for HIV+ women not receiving treatment, but goes down to <2% for women who start treatment early in their pregnancy.