HIV and pregnancy

The United States Preventive Services Task Force, United States Centers for Disease Control and Prevention, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists recommend that all pregnant women be screened for human immunodeficiency virus (HIV) infection. This is because early detection and treatment are the key to preventing newborn HIV infection.¹

Although your health professional may not offer an HIV test as part of your routine prenatal care, it's a good idea to have one. If you have any risk factors for HIV infection, your health professional may want to give you a second test later in your pregnancy.

If you or your partner has ever had unprotected sex (or shared needles) with a person whose HIV status is unknown, there is a chance that you have the virus. If you do have HIV, your baby could also become infected. HIV infects about 1 of every 4, or 25%, of newborns born to untreated HIV-infected women. The virus is usually passed on during labor and childbirth, although it sometimes is passed in utero.¹ Breast-feeding also passes the virus from mother to baby.

Treatment with medicines called antiretrovirals, both during pregnancy and after the birth, greatly reduces a baby's risk of HIV infection. Antiretroviral medications prevent the virus from multiplying. When the amount of HIV in the blood is minimized, the immune system has a chance to recover and grow stronger. In one large study of HIV-positive pregnancies, the rate of infant infection dropped from 25% to about 8% when mothers and babies were treated.¹

Current treatment recommendations include:

• Antiretroviral treatment for the mother, during the second and third trimesters and during childbirth. Zidovudine (ZDV), sometimes in combination with other antiretrovirals, is the treatment of choice during pregnancy.
• Planned cesarean delivery for women with a high level of HIV antibodies (viral load) and therefore a higher risk of infecting their babies. Only 2% of babies become infected after being delivered by cesarean (before labor begins) to HIV-positive mothers.¹
• Antiretroviral treatment for the baby for 6 weeks after birth. ZDV is the treatment of choice.
• No breast-feeding.

For more information, see the topic Human Immunodeficiency Virus (HIV).

Citations

1. American Academy of Pediatrics (2002). Human immunodeficiency virus section of Perinatal infections. In Guidelines for Perinatal Care, 5th ed., pp. 297–302. Washington, DC: American Academy of Pediatrics.