HIV, AIDS, and Pregnancy
What are HIV and AIDS?
HIV is the abbreviation used for the human immunodeficiency virus. HIV is the virus that causes
AIDS (acquired immunodeficiency syndrome), a life-threatening disease.
HIV attacks the body's immune system. It destroys infection-fighting cells. When these cells are
destroyed, the immune system can no longer defend the body against infections and cancers.
HIV infection becomes AIDS when you lose your ability to fight off serious infections or tumors.
Various infections called opportunistic infections develop. They are called opportunistic because
they take advantage of the weakened immune system. These infections would not normally cause
severe or fatal health problems. However, when you have AIDS, the infections and tumors are
serious and can be fatal.
If you are pregnant and you are infected with HIV, your baby may be infected by the virus before
or during birth. The baby can also get the virus from your breast milk. Babies who are infected may
become very sick and die.
Without treatment, about one third of babies born to HIV-infected mothers become infected with
the virus. You should be tested for HIV before you become pregnant, or at least at your first
prenatal visit. If you are infected with HIV, treatment can help prevent spread of the infection to
your baby.
How does HIV infection occur?
You can become infected with HIV through:
unprotected sexual activity
shared needles
contact with infected blood or semen
transfusion with infected blood (now rare in the US because of current screening tests).
HIV can be passed to an unborn baby through the placenta, by exposure to blood and body fluids
during labor and at delivery, or through breast-feeding.
What are the symptoms?
You can be infected with HIV and not have any symptoms. Or you may have one or more of the
following signs and symptoms, such as:
fever that lasts from a few days to longer than a month
loss of appetite or weight, especially loss of more than 10% of body weight
prolonged swelling of the lymph nodes
sore throat
long-lasting or multiple viral skin problems, such as herpes sores or plantar warts
repeated, severe yeast infections in your mouth or vagina despite treatment
chronic muscle and joint pain
diarrhea, especially if it lasts longer than a month
headache.
How is HIV infection diagnosed?
Usually the first test, the ELISA test, is a blood test although in some hospitals and facilities a new
test that involves swabbing the gums may be done. The ELISA test is done to see if you are
infected with HIV. If this test is positive, another more specific blood test, usually the Western blot
test, is done to confirm the results. If both tests are positive, you are infected with HIV. Tests can
usually detect HIV infection within several weeks of exposure to the virus. HIV tests are always
strictly confidential whether the results are positive or negative.
If you are pregnant and refuse to be tested for HIV, you will need to sign a form for your healthcare
provider which will be placed in your medical file.
How is it treated?
The earlier that HIV is diagnosed and treated during pregnancy will reduce the chances that HIV
will spread to the baby. If you are pregnant and have tested positively for HIV, your healthcare
provider will probably prescribe the antiviral drug zidovudine (also called ZDV or AZT). Other
HIV-fighting drugs may be prescribed as well. It is not likely that you or your baby will have
significant side effects from the drug treatment and it may help prevent spread of the virus to the
baby.
Having a cesarean section (C-section) instead of a vaginal delivery also reduces the risk of
infecting the baby. The C-section should be planned before the due date to prevent labor and
delivery and early rupture of the membranes. Taking the medicine and having a C-section reduces
the risk to a 2% chance of passing on the infection.
You may need to be treated with medicine for opportunistic infections such as pneumonia, TB, a
yeast infection, or toxoplasmosis. You may also need treatment for other diseases that are common
in people with HIV, such as herpes, hepatitis, or syphilis.
During labor and delivery you do not need to be isolated. All hospital personnel use special
precautions when they handle blood or other body fluids to prevent the spread of AIDS. If you are
having a C-section, you will probably need antibiotics to help prevent your getting an infection
during the surgery. Make sure that you tell all your healthcare providers that you are HIV positive.
Your baby will be treated with ZDV right away after delivery, and for at least the first 6 weeks of
life to help prevent infection. You should not breast-feed your baby. Give formula to your baby
instead of breast milk to help prevent spread of the virus to the baby.
If a baby is born infected with HIV infection, the baby will be treated with antiviral drugs.
How will I know if my baby has an HIV infection?
Your baby will be tested for HIV after birth. However, because some of your antibodies to HIV
may be passed on to the baby, the test results are not always completely accurate. If a newborn's
tests are negative, you cannot be sure that the child is not infected with HIV until many months
later. You will need to have your baby tested again after several months.
What can be done to help prevent HIV infection during
pregnancy?
Ask for counseling and testing if you are pregnant or plan to become pregnant and are in any of the
following high-risk groups:
intravenous (IV) drug abusers and other drug abusers, such as cocaine addicts
sexual partners of HIV-infected men or men in high-risk groups (such as drug abusers or
bisexual men) if they do not always use a latex or polyurethane condom
women who have lived for a long time in an area where a lot of people are infected with HIV or
who have given birth in such an area (such as Haiti and east central Africa)
prostitutes
women with more than 1 sexual partner or whose sexual partner is sexually active outside the
relationship (especially women who live in areas where there is a high occurrence of HIV
infection)
women given transfusions of blood or blood products in countries where the blood is not
rigorously tested
women who have cancer of the cervix.
Know your partner. Ask about your partner's sexual history and if your partner has ever used IV
drugs. Do not share toothbrushes, razors, or other items that may be contaminated with body
fluids.
It is recommended that all women be tested for HIV before they get pregnant.
If you know that you are infected with HIV, you should seriously consider the grief and high cost
of having a baby infected with HIV. Try to avoid becoming pregnant. Follow safe sex practices
(including the use of latex or polyurethane condoms) to prevent the spread of the infection to
others