From the early days of the community learning about HIV, there have been a lot of questions and misconceptions about HIV. There have also been many advancements in the understanding of HIV and pregnancy. To understand how HIV affects pregnant women and their unborn child, it is important to understand what HIV is and how it can be contracted.
So, what is HIV? HIV stands for “Human Immunodeficiency Virus.” Human Immunodeficiency Virus (HIV) is a virus that damages the immune system over time and is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Our immune systems work on our behalf to keep us healthy and fight off infections. Many people with HIV do not know that they have HIV because they feel and appear healthy. They can infect others without even knowing it. While there is no known cure for HIV or AIDS, there are many treatments and trials that provide a better quality of life and, in some cases, extend the lives of those diagnosed with either HIV or AIDS.
Let’s talk about how you DON’T get HIV. You don’t get HIV from touching, hugging, or being around a person with HIV. You can’t get HIV from bug bites or mosquitos. You can’t get HIV from kissing unless one of you has an open sore or cut in/outside the mouth. You can’t get HIV from giving blood. HIV is not transmitted through saliva.
Now, how CAN you contract HIV? HIV is transmitted through blood and bodily fluids including semen, vaginal secretions and breast milk. Basically, there has to be a way for the HIV virus to exit the infected person and an entry for the HIV virus to enter your body. The three most common ways to contract HIV is through unprotected sexual intercourse, sharing needles, and from mother to infant.
How do I know if I have HIV? The Centers for Disease Control (CDC) recommend that women who may become pregnant, or who are pregnant, have an HIV test as soon as possible. If you are already pregnant, you may request an HIV test at any time during your pregnancy, usually at the first prenatal appointment. The earlier, the better to reduce the chance of mother to baby transmission.
If you test HIV-negative and have unprotected sex or share needles, you should be tested again during the pregnancy. You should ask to be tested again in your third trimester as sometimes it takes time for the virus to be present in blood tests. It is a good idea to be tested because you could have been exposed to HIV through unprotected sex, without knowing it and even without your partner knowing it. If you share needles, you may also be at higher risk of contracting HIV so a repeat HIV test is recommended.
Will my baby have HIV if I am HIV positive? If you discover that you are HIV positive during pregnancy, meet with your healthcare provider to discuss treatment options. You should begin treatment immediately and MUST follow your recommended treatment protocol during pregnancy, labor, delivery, and breastfeeding (and beyond) to reduce the possibility of passing HIV on to the baby. It is possible to deliver a baby that is not HIV positive. The earlier you begin antiviral treatment, the better the chances that your baby will not be HIV positive. If you test HIV positive, your newborn MUST take an antiviral treatment protocol to reduce the baby’s chances of becoming infected with HIV.
Most women that are HIV positive have their babies delivered through caesarean section (C-section). However, some women that are HIV positive can have vaginal deliveries if they have a low viral load (low level or undetectable HIV in blood).
In resource-rich countries, such as the United States, women that are HIV positive are strongly advised to use baby formula to feed their infants. Baby formula is the safest feeding method for infants born to HIV positive mothers. However, if you do not have access to baby formula, sterile bottles and clean water daily, breastfeeding may be your only option. In this case, it is even more important for you to continue to take your treatment protocol daily and for your baby to take her treatment protocol as well. Even if the mother and baby are both on antiviral medications, there is still a chance of passing HIV on to the infant through breast milk.
Thanks to research, education, and improved treatments, many people with HIV live long, healthy lives. As with most illnesses, prevention, early detection and strict adherence to treatment protocols can lead to favorable outcomes. If you think you might have been exposed to HIV or would like to learn more about HIV and pregnancy, contact one of our Bay Area pregnancy clinics. Our caring and supportive nurses and patient advocates are here to answer your questions and address your concerns.