What You Need to Know About HIV and Pregnancy

Giddyngenoh

Due to advances in HIV care and treatment, many women living with HIV are living longer, healthier lives. As women living with HIV think about their futures, some are deciding to have the babies they always wanted.

After you’re diagnosed with HIV and on regular treatment, you’ll still need to have regular checkups with your doctor to make sure the treatment is working well for you. Your doctor will give you tests that check:

Viral load. Every person with HIV has a different measure of the virus in their blood, known as their viral load. Knowing your HIV viral load is important because it shows how well your treatment is working. A low viral load also means that there is a lower risk of passing on HIV to someone else, including your baby.

CD4 Count. This test determines the number of C4D cells that are in your blood. CD4 cells, also called T cells, are white blood cells that help your immune system fight infections. If you have HIV and are not treated, the virus may gulp up these cells, making it more challenging to fight infections and leading to other health issues. However, with the right treatment, you can manage HIV and increase your CD4 cell count.

The good news is that advances in HIV treatment have also greatly lowered the chances that a mother will pass HIV on to her baby (also known as perinatal HIV transmission, or vertical transmission; also sometimes called "mother-to-child" transmission). When mothers are NOT taking HIV drugs, HIV can be perinatally transmitted to the baby.

There are three ways a baby can become HIV positive (perinatal transmission):

During pregnancy. While the baby is still in the womb, HIV can be transmitted through blood in the placenta.

During labor and delivery. If the baby comes in direct contact with your blood during delivery, or other liquids like the fluid inside the amniotic sac that surrounds the baby like a balloon, there’s higher risk of HIV transmission.

Through breastfeeding. There’s up to a 10 to 20 percent chance of a baby getting HIV through nursing.

If you have HIV, it doesn’t mean that your baby will get it. It’s possible to lower the risk of passing on HIV to your baby through:

Medication

Most HIV drugs are safe when taken during pregnancy, and studies have shown that the developing baby is healthier when the mother begins HIV treatment before getting pregnant. In general, pregnant women living with HIV can take some of the same HIV treatment recommended for women who are not pregnant.

Feeding strategy

Although there’s a lower risk of transfer while breastfeeding, your doctor may recommend not nursing your baby. It’s also important to not pre-chew your baby’s food.

Delivery method

Your doctor may recommend that you have a cesarean (C-section) delivery to lower the risk that your baby will get HIV during birth.

You may have the option of a vaginal delivery if your HIV is well managed and your viral load isn’t detectable (meaning you have a very low amount in your body).

Breastfeeding

Nursing can offer health benefits for your baby. However, if you’re HIV positive, it may be best for your baby to be formula-fed. HIV can be passed on to your baby through your milk even if you have a very low viral count.

There are options to reduce the risk that a woman will pass on HIV while breastfeeding. The mother should ensure that she is virally suppressed and knows about the option for her baby to be provided ARV prophylaxis beyond the standard 6-week course typically given to babies born to women with HIV.

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