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Perinatal HIV

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Jun.02.2022
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 Perinatal HIV

Perinatal HIV

Many women with HIV (human immunodeficiency virus) are able to have healthy pregnancies and deliver healthy babies. However, if you have HIV, there is a risk that you can pass the virus on to your baby anytime during pregnancy, labor, delivery, or breastfeeding. This is called perinatal HIV transmission, or mother-to-child transmission.

The chances of perinatal transmission are lower if you take HIV medicines, also called antiretroviral therapy (ART). ART medicines do not cure HIV, but they help to slow the growth of the virus, thus keeping it from spreading to your baby.

How does this affect me?

Having HIV may affect you during pregnancy and labor and delivery. It may also affect you after you give birth. Women with HIV:
  • Will need testing and medicines to help control the virus during pregnancy.
  • Are more likely to need a cesarean delivery (C-section). This usually happens at 38 weeks of pregnancy.
  • May not be able to breastfeed after the baby is born.

How does this affect my baby?

During pregnancy

  • Some HIV medicines have been linked to birth defects. However, treating HIV during pregnancy is more beneficial to your baby than it is harmful.
  • Perinatal HIV transmission during pregnancy is rare. However, you are more likely to pass the virus to your baby if you:
    • Smoke or use drugs.
    • Have a vitamin A deficiency or other nutrient deficiency.
    • Have another sexually transmitted infection (STI).
    • Do not treat HIV during pregnancy.
    • Have high amounts of HIV virus in your blood (high viral load).
  • Perinatal HIV transmission is more likely to happen during labor and delivery, but it is still rare.

After delivery

After your baby is born, he or she:
  • May have side effects from ART medicines. These problems are minor, and they get better after birth.
  • Will likely need ART medicines to help protect him or her from getting the virus. Your baby may need to take medicines within 6 hours of being born and up to 6 weeks after birth.
  • May not be able to breastfeed. You may need to feed your baby formula instead.
  • May need ongoing medical care and monitoring as he or she grows.

There is no way to guarantee that your baby will be born without HIV. Taking ART medicines and following your health care provider's instructions before and during pregnancy will help lower the risk of passing HIV to your baby.

What can I expect during labor and delivery?

Your health care provider will plan your labor and delivery according to your viral load.
  • Your health care team will give you ART medicine through an IV a few hours before delivery.
  • If you have a low viral load, you may be able to have the same type of labor and delivery as an uninfected woman. This means that you will have a vaginal delivery, or a cesarean delivery if needed.
  • If you have a high viral load, you will receive extra care and deliver your baby by scheduled cesarean delivery.
  • You will continue to take your ART medicines on schedule as much as possible.

Follow these instructions at home:

Medicines

  • Take your ART medicines exactly as told by your health care provider. This is the most important thing you can do for your health and your baby's.
  • To fully protect you and your baby, your health care provider will:
    • Start you on ART treatment if you are not already on the medicines.
    • Keep you on your current ART treatment if you are already taking the medicines.
    • Make some changes to your ART treatment to make sure you are getting the best possible treatment.
  • Keep taking your ART medicines after your baby is born.
  • Take over-the-counter and prescription medicines only as told by your health care provider. This may be needed to treat infections or side effects of ART.

Eating and drinking

  • Eat a balanced diet that includes fruits and vegetables, whole grains, protein foods, and dairy.
  • Do not drink alcohol.
  • Take a prenatal multivitamin that has 400 mcg of folic acid.

Feeding your baby

  • Breastfeeding is generally not recommended due to the risk of passing the virus on to your baby through breast milk. Talk with your health care provider about the risks and benefits of breastfeeding. Your health care provider will help you make a decision that is right for you.
  • If you choose not to breastfeed, talk with your health care provider about your options. These may include bottle-feeding infant formula or donated breast milk from a human milk bank.
  • Do not give your baby any food that you have chewed. This increases your baby's risk for HIV.

Caring for your baby

  • Start medical care for your baby right after birth. Your baby's health care provider (pediatrician) should see your baby shortly after birth and regularly during the first year.
  • Give your baby all of his or her ART medicines as told by the health care provider. This is very important.
  • Make sure that your baby gets tested for HIV at all of these ages:
    • 2–3 weeks old.
    • 1–2 months old.
    • 4–6 months old.

General instructions

  • Keep all follow-up visits as told by your health care team. This is important. Regular visits may be planned for both you and your baby.

Contact a health care provider if:

  • You are having trouble stopping your use of tobacco, alcohol, or other drugs.
  • You have concerns about your viral load.
  • You are not able to take your ART medicines.

Summary

  • Many women with HIV are able to have healthy pregnancies and deliver healthy babies.
  • Take your ART medicines exactly as told by your health care provider. This is the most important thing you can do to lower your baby's risk for HIV.
  • Make sure your baby gets ART medicines as told by your health care provider. Your baby should also get tested for HIV according to your health care provider's instructions.
  • Keep all follow-up visits for yourself and your baby.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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