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HIV and Pregnancy: Ways to Prevent Mother-to-Child Transmission of HIV

It’s stressful to receive an HIV diagnosis, and it’s normal to wonder whether it will affect your ability to have healthy children. Thankfully, modern science has made great advancements in recent years.

Nowadays, you can have healthy children, even if you or your partner have HIV. Let’s talk about HIV and pregnancy.

Every woman should try to be as healthy as possible before getting pregnant. Maintaining a healthy lifestyle while trying to conceive is one of the easiest and most effective ways to maximize your chances of a healthy pregnancy.

If you’re looking to get pregnant and you have HIV, it’s very important to discuss your options with your doctor. They will be able to give you the best advice on how to have a healthy pregnancy and lower the risk of mother-to-child transmission.

It is very important to take your HIV treatment exactly as instructed by your physician. Following your HIV treatment can help you reach an undetectable viral load. Women who don’t receive any type of treatment during pregnancy, delivery, or breastfeeding have a 15–45 percent chance of passing the virus on to their babies. But if you maintain an undetectable viral load during your pregnancy, the chances of passing the virus to your baby fall to just 0.1 percent. The World Health Organization recommends lifelong antiretroviral therapy for all people with HIV. This includes women who are pregnant or breastfeeding.

An undetectable or very low viral load can also prevent transmission to your partner as you try to conceive.

Yes! There are several ways to get pregnant safely if your partner has HIV. If you’re the one who’s HIV positive, you can also conceive without passing the virus to your partner.

The first thing you need to do is get screened for other sexually transmitted infections (STIs). Having another STI can greatly increase the risk of HIV transmission. If you are trying to conceive with a partner who has HIV, it is also recommended that they get a semen analysis before trying to conceive.

Women who don’t receive any type of treatment during pregnancy, delivery, or breastfeeding have a 15–45 percent chance of passing the virus on to their babies.

The most effective way to get pregnant while still preventing HIV transmission is to make sure that your partner has an undetectable viral load. If your partner has an undetectable viral load, the risk of getting HIV from them goes down to zero. 

If your partner has a low viral load, your doctor could counsel you on whether you could try intercourse without a condom. Having condomless sex strictly during your fertile window can significantly reduce the risk of HIV transmission. It’s important to remember that if your partner has a detectable viral load, using a condom is the most effective way to prevent transmission.

You can also ask your doctor for a prescription for pre-exposure prophylaxis (PrEP). PrEP consists of taking certain HIV medications before being exposed to the virus, and it can greatly decrease your risk of getting infected.

It’s important to remember that if your partner has a detectable viral load, using a condom is the most effective way to prevent transmission.

Sperm washing is another option. During this procedure, your partner’s sperm cells are separated from the seminal fluid that contains the virus. Then, the sperm cells can be used to perform different assisted reproduction procedures such as in-vitro fertilization or intrauterine insemination. Other couples choose to use donor sperm.

The most important thing you can do during an HIV pregnancy is to continue to take your medications. Your antiretroviral drugs will not only keep you healthy during this time, but they can also help prevent passing the virus to the fetus.

Antiretroviral therapy can decrease your viral load, ensuring that your baby will be exposed to lower amounts of the virus while they’re inside your womb. Additionally, certain types of HIV drugs can cross the placenta and enter your baby’s bloodstream. Thanks to this effect, your baby will receive further protection from HIV transmission.

If you get a positive HIV test during pregnancy, your doctor will probably recommend that you start antiretroviral therapy as soon as possible. The sooner you begin your treatment, the lower your viral load will be by the time the baby is due.

Antiretroviral therapy can decrease your viral load, ensuring that your baby will be exposed to lower amounts of the virus while they’re inside your womb.

After the baby is born, they will probably need to take HIV therapy for a short time. This can further decrease their risk of contracting the virus. This is called infant post-exposure prophylaxis, or infant PEP, and it must be started at least within four hours of delivery.

Your baby’s pediatrician will choose the best HIV therapy for them based on your viral load. The drugs used for infant PEP are safe for your baby, and they usually need to be taken for approximately four to six weeks.

Yes. Women who are HIV positive and pregnant usually keep taking the same medications they took before getting pregnant. Of course, your doctor has to review and approve any treatment changes made during pregnancy. 

Antiretroviral drugs are safe both for you and your baby. Certain studies have linked HIV drugs with premature labor. However, the evidence supporting this claim is mixed, and the benefits of HIV therapy during pregnancy far outweigh any possible risks. 

Whether or not a C-section can reduce the risk of transmitting HIV to your baby depends on your viral load. If you have an undetectable viral load and take combination antiretroviral therapy, a vaginal delivery won’t increase your baby’s chances of getting HIV. Research has shown that HIV-positive women who have an undetectable viral load can deliver HIV-negative babies vaginally.

If your viral load is still detectable or unknown, your doctor will probably recommend scheduling a C-section before you go into labor.

If you have an undetectable viral load and take combination antiretroviral therapy, a vaginal delivery won’t increase your baby’s chances of getting HIV.

If you go into premature labor and have an undetectable load, you could still deliver vaginally. However, if you go into premature labor but your load is detectable, you will most likely need a C-section.

You might have an undetectable viral load but still need a C-section for another medical reason. Your doctor will evaluate your case before and during labor to make the best decision for you and your baby.

Even if your viral load is undetectable, it’s still recommended that you avoid breastfeeding your baby if you have HIV. Unlike for sexual transmission, research hasn’t been able to fully prove whether HIV becomes untransmittable via breastfeeding with an undetectable viral load.

The virus can be present in breast milk, so baby formula is the preferred alternative. Formula is safe and can cover all your baby’s nutritional requirements during their first months of life. If you’re HIV positive, mixing your breast milk with other foods can increase the risk of HIV transmission.

Even if your viral load is undetectable, it’s still recommended that you avoid breastfeeding your baby if you have HIV.

However, an exception is made for women who don’t have steady access to formula or clean water. In these cases, women are advised to breastfeed exclusively for at least six months. Both mother and child should take antiretroviral therapy. Breastfeeding is recommended in this scenario because in lower-income settings, the risk of malnutrition and infant mortality is considered to be more important than the risk of HIV.

Babies born from an HIV pregnancy will need to be tested for the virus a few hours after they are born. They will get tested again at 6 and 12 weeks old. The results of these tests will help determine the best course of treatment for the baby.

Once your baby is 18 to 24 months old, they will be tested for HIV antibodies. After this test, your baby will be considered to be HIV negative. If any tests come back positive, your baby will probably be referred to a pediatrician that specializes in treating children with HIV.

If you received your first positive HIV test in pregnancy and you have previous children, it is important to get them tested for HIV. 

The easiest and most effective way to know whether your baby is HIV positive is through an HIV test. Even if your child tested negative for the virus at birth, it’s very important to repeat the test as recommended. Remember that HIV can remain without symptoms for a long time, which is why getting an early diagnosis is so important to prevent its spread.

Just a couple of decades ago, having healthy HIV pregnancies seemed impossible. But thanks to modern therapies, people with HIV can have kids who are healthy and HIV negative. If you are HIV positive and thinking about getting pregnant, your doctor can advise you on how to achieve a healthy and happy family.

The easiest and most effective way to know whether your baby is HIV positive is through an HIV test.

HIV in pregnancy doesn’t have to cause severe complications. Even if you weren’t diagnosed before your pregnancy, getting the right HIV treatment during pregnancy, delivery, and breastfeeding can result in having a healthy child. And if your viral load is undetectable, you could even have a vaginal delivery without fear of HIV transmission.

https://www.womenshealth.gov/hiv-and-aids/living-hiv/pregnancy-and-hiv
www.aidsmap.com/about-hiv/pregnancy-and-birth

https://www.hiv.gov/hiv-basics/hiv-prevention/reducing-mother-to-child-risk/preventing-mother-to-child-transmission-of-hiv

http://www.aidsmap.com/about-hiv/undetectable-viral-load-and-transmission-information-people-hiv

https://www.thewellproject.org/hiv-information/getting-pregnant-and-hiv-man-living-hiv-and-hiv-negative-woman-serodiscordant-or

https://www.avert.org/hiv-transmission-prevention/pregnancy-childbirth-breastfeeding

https://www.stanfordchildrens.org/en/topic/default?id=aidshiv-in-children-90-P02509

https://www.who.int/news-room/fact-sheets/detail/hiv-aids

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