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). AIDS is a life-threatening disease.

HIV attacks the body's immune system. The immune system is the body's defense against infections. With time, HIV weakens your ability to fight off serious infections and tumors. When this happens, HIV infection becomes AIDS. Other, opportunistic infections develop. The infections are called opportunistic because they take advantage of the weakened immune system. These infections normally would not cause severe or fatal health problems. However, when you have AIDS, the infections and tumors are more serious and are harder to treat successfully.

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 infected with HIV may get very sick and die.

How does HIV infection occur?

You can get infected with HIV through:

• Unprotected sexual activity
• shared needles
• contact with infected blood or semen
• transfusion of blood or blood products in countries where the blood is not carefully tested

A mother who is infected with HIV can pass the virus to an unborn baby through:

• the placenta
• exposure of the baby to the mother’s blood and body fluids during labor and at delivery

After delivery, HIV can be passed to a baby by breast-feeding.

What are the symptoms?

Most women who are infected with HIV have no symptoms. Some women do have one or more of the following signs and symptoms, such as:

• fever
• loss of appetite or weight
• nausea and vomiting
• tiredness
• swollen “glands” (lymph nodes)
• sore throat
• sores on the skin or mouth
• repeated, severe yeast infections in the mouth or vagina despite treatment
• muscle and joint pain
• diarrhea
• headache
• blurry vision or other problems with vision

How is HIV infection diagnosed?

Tests for HIV are done in 2 steps. The first test is a screening test of your blood or saliva. If this test is positive, a second, more specific blood test is done to confirm the results. Tests can usually detect HIV infection within several weeks after you were exposed to the virus.

All women should be tested for HIV before they get pregnant. You should also be tested at your first prenatal visit. If you are infected with HIV, treatment during the pregnancy can help prevent spread of the infection to your baby.

The chances that HIV will spread to the baby are lower when the infection is diagnosed and treated early in pregnancy.

How is it treated?

If you are pregnant and have tested positively for HIV, your healthcare provider will probably prescribe an antiviral drug, such as 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 bad side effects from the drug treatment and it may help prevent spread of the virus to the baby. If you have a lot of virus in your body, having a cesarean section (C-section) instead of a vaginal delivery can also reduce the risk that you will infect the baby. Taking the medicine and having a C-section reduces the risk to a 2% chance that the baby will get infected.

You may need to be treated with medicine for opportunistic infections such as pneumonia, TB, yeast infection, and toxoplasmosis.

During labor and delivery you don’t need to be isolated. All hospital personnel use special precautions when they handle blood or other body fluids to prevent the spread of infections, including HIV. Make sure that you tell all of your healthcare providers that you are HIV positive.

Your baby will be treated with an antiviral drug 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.

How will I know if my baby has an HIV infection?

Your baby will be tested for HIV after birth. However, if you have HIV, some of your antibodies to HIV may be passed on to the baby. This can affect the test results. If your 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.

How can I help prevent HIV infection during pregnancy?

Ask for counseling and testing if you are pregnant or plan to get pregnant and are in any of the following high-risk groups:

• people who share needles (for IV drug use, tattooing, or piercing)
• sexual partners of HIV-infected men or men in high-risk groups (such as drug abusers or bisexual men)
• women or their partners who have lived for some time in an area where a lot of people are infected with HIV (such as Haiti, east central Africa, and other developing parts of the world)
• prostitutes
• women with more than 1 sexual partner or whose sexual partner is sexually active outside the relationship
• women given transfusions of blood or blood products in countries where the blood may not be rigorously tested for HIV

Know your partner. Ask about your partner's sexual history and if your partner has ever used IV drugs. Don’t share toothbrushes, razors, or other items that may have body fluids on them.

If you know that you are infected with HIV, you should think about avoiding pregnancy. Seriously consider the grief and high cost of having a baby infected with HIV. Follow safe sex practices, including the use of latex or polyurethane condoms, to prevent the spread of the infection to others.