HIV and Pregnancy
Just because you are HIV positive does not mean you cannot become pregnant. Nor does it mean that you can’t give birth to a healthy, HIV-negative baby. You should understand though, that there is some risk associated with pregnancy when you are HIV positive, because it is possible to transmit the human immunodeficiency virus (HIV) to your baby during pregnancy, childbirth, or when breastfeeding.
According to the Center for Disease Control, if you are HIV positive, you can reduce the risk of transmitting the virus to your baby to as low as 1%, by taking HIV-related medications exactly as prescribed by your healthcare provider.
How Can I Lower My Risk of Passing HIV to My Unborn Baby?
If you are pregnant and have HIV, the best way to reduce any chance of passing the infection on to your baby is to remain as healthy as possible. Your healthcare provider can advise you concerning ways to protect yourself and your unborn child from HIV-related complications. Click here to learn more about HIV treatment medications.
90% of Babies Born to HIV Positive Mothers Do Not Have HIV
According to the Office on Women’s Health (U.S. Department of Health and Human Services), the number of babies born with HIV has fallen by 90% since the mid-1990s. This is believed to be directly related to the use of antiretroviral medications alongside other HIV-positive pregnancy treatment protocols.
If You Are Pregnant or Considering Becoming Pregnant, Get Tested for HIV
Knowing your HIV status can help you make informed healthcare decisions. If you are considering becoming, or are already pregnant, and you don’t know your HIV status, you should be tested as soon as possible. Click here.
Even if you are already pregnant, you can become infected if you have unprotected anal, oral, or vaginal sex, share contaminated needles, or share “works” (injection equipment including water and cotton), piercing, and or tattooing needles.
When Should I be Tested for HIV During Pregnancy?
It is recommended that you have an HIV test at your first prenatal visit, during your third trimester, and after delivery. Even if you have declined a previous HIV test, you can still ask for one at any time. You should also ask your partner to be tested at least once.
And, if you do have unprotected sex or share needles at some point during your pregnancy, you should be tested for HIV again.
Why should I be tested for HIV more than once?
If you have been tested and it came out negative, there is a chance that you were tested in what is known as the window period. The window period is a length of time in which your body has not created enough antibodies for the test to detect, even though you are actually infected.
If you think you have been exposed to HIV recently, you should talk to your healthcare provider about follow-up testing. Fortunately, some of the newer tests can dramatically reduce the window period from weeks to as little as 11 days after infection. Click here to learn more about the window period and HIV testing. Click here.
What if I cannot afford HIV testing?
Testing is simple, fast, and painless. If you cannot afford an HIV test, low cost and or no-cost tests are available. Your local health department, for instance, may offer free testing. Many Planned Parenthood locations also offer either low-cost or free HIV tests as well as other services for those who cannot afford them.
Additionally, many substance abuse centers, local health departments, community clinics, and hospitals either offer free or low-cost testing, and or can advise you where to go so you can be tested. You can also use the low-cost/free testing site locator provided by the Center for Disease Control by clicking here.
Starting HIV Treatment While Pregnant
If you are pregnant and test positive for HIV, you should talk to your doctor about starting treatment as early as possible, even if you do not have symptoms. (Many people do not experience symptoms for as much as a decade or more after becoming infected.)
You can still transmit the virus to your unborn child if you are infected but not showing any symptoms.
Will taking Antiretroviral HIV Medications (ART) increase my baby’s risk of birth defects?
Your healthcare provider can discuss the potential benefits and risks of HIV treatment during pregnancy, as well as which medications are right for you and your baby.
If I do not have HIV, but my partner does, can I get pregnant?
Women are at greater risk of becoming infected with HIV during vaginal intercourse than their male partners are. If your partner is HIV positive, you can drastically reduce your risk of becoming infected by using pre-exposure prophylaxis, or PrEP. You should know that stopping the medication or skipping doses makes the medication much less effective.
Your healthcare provider can explain how a once-daily medication can lower your risk of becoming infected by as much as 90%. Click here to read more about PrEP therapy.
Pregnancy: HIV and Sperm Washing
Even if your partner is HIV positive, there are other options to help you become pregnant. You might consider invitro fertilization using a process known as sperm washing. Sperm washing is used to remove the virus from the semen of HIV positive males before artificially inseminating the female.
The Center for Disease Control (CDC) has determined the process is both safe and effective for couples wishing to become pregnant when the male partner has HIV and the female is HIV negative. Your doctor can explain the process to you, as well answering any questions you may have.
Preventing Perinatal HIV Transmission (Mother to Child HIV Infection)
Healthy mothers are more likely to give birth to healthy babies. HIV medications can reduce your HIV viral load (the amount of virus within your body).
According to the National Institute of Health, higher levels of maternal viral load increase the risk of passing HIV to the child during pregnancy, childbirth, or breastfeeding. The lower the load, the less risk that your child will become infected with HIV.
Vaginal Delivery, C-Section and HIV
Additionally, certain HIV mediations can cross the placenta (also called the afterbirth). The transfer of antiretroviral medications may help protect the baby during delivery. (When the baby comes into contact with vaginal fluids, blood, and the birth canal.) Your healthcare provider may also talk to you about having a C-section to further reduce the risk of infecting your baby.
Breastfeeding and HIV
Per the Center for Disease Control, if you are HIV positive, you should not breastfeed your baby. Baby formula is considered a safe alternative to breast feeding. You can also use pre-tested, donated milk. Screened donor milk is often available at local milk banks and or hospitals.
Because donated and screened breast milk can be in short supply, it is frequently saved for high-need infants such as those in hospital neonatal units. If it is available in your area, your pediatrician can give you a prescription which allows you to receive safely donated/tested breast milk.
You should also avoid pre-chewing food for your child, as there have been reports of children becoming infected after being fed pre-chewed food from HIV infected adults. For more information about HIV and how ASP Cares can help, please follow our blog or contact us.
If you, or someone you care about is considering becoming, or is pregnant and has HIV, we can help. ASP Cares is a leading specialty pharmacy serving the HIV/AIDS community.
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This content does not represent medical advice. It is not meant to diagnose or treat any condition. It is not intended as a substitute for the advice of a qualified medical provider.