HIV/AIDS during Pregnancy

According to the March of Dimes, there are an estimated 120,000 to 160,000 women in the United States who have been infected with HIV. About 6,000 to 7,000 of women infected with HIV give birth annually. Since the beginning of the HIV/AIDS epidemic, approximately 15,000 children in the United States have been infected with HIV and 3,000 children have died. About 90 percent of those were infected with the virus during pregnancy or birth.

HIV transmission from mother to child during pregnancy, labor, delivery or breastfeeding is called perinatal transmission. Perinatal HIV transmission is the most common way children are infected with HIV.

What is HIV/AIDS?

HIV (Human Immunodeficiency Virus) is a virus that causes AIDS (Acquired Immunodeficiency Syndrome). A person may be “HIV positive” but not have AIDS. An HIV infected person may not develop AIDS for 10 years or longer. A person who is HIV positive can transmit the virus to others when infected blood, semen or vaginal fluids come in contact with broken skin or mucus membranes.

An AIDS infected person cannot fight off diseases as they would normally and are more susceptible to infections, certain cancers and other health problems that can be life-threatening or fatal.

What are the risk factors for transmitting HIV during pregnancy?

If a woman is infected with HIV, her risk of transmitting the virus to her baby is reduced if she stays as healthy as possible. According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a 2 percent or less chance.

Factors which increase the risk of transmission include:

• Smoking
• Substance abuse
• Vitamin A deficiency
• Malnutrition
• Infections such as STD’s
• Clinical stage of HIV, including viral load (quantity of HIV virus in the blood)
• Factors related to labor and childbirth
• Breastfeeding

Should pregnant women get tested for HIV? How is testing done?

Women who are planning on becoming pregnant or who are pregnant should be tested for HIV as soon as possible. The woman’s partner should also be tested. The March of Dimes recommends that all women of childbearing age who may have been exposed to HIV should be tested before becoming pregnant. Women who have not been tested before becoming pregnant should be offered counseling and voluntary testing during pregnancy. Women who have not been tested during pregnancy can be screened during labor and delivery with rapid tests which can produce results in less than one hour. This allows for treatment to protect the baby should the results be positive.

HIV/AIDS testing is conducted with a blood test.

A woman’s health care provider may offer testing and counseling or may refer her to a local testing sight.

How can HIV/AIDS affect my pregnancy?

In most cases, HIV will not cross through the placenta from mother to baby. If the mother is healthy in other aspects, the placenta helps provide protection for the developing infant. Factors that could reduce the protective ability of the placenta include in-uterine infections, a recent HIV infection, advanced HIV infection or malnutrition.

Unless a complication should arise, there is no need to increase the number of prenatal visits. Special counseling about a healthy diet with attention given to preventing iron or vitamin deficiencies and weight loss as well as special interventions for sexually transmitted diseases or other infections (such as malaria, urinary tract infections, tuberculosis or respiratory infections) should be part of the prenatal care of HIV infected women.

Health care providers should watch for symptoms of AIDS and pregnancy-related complications of HIV infection. In addition, providers should avoid performing any unnecessary invasive procedures such as amniocentesis in an effort to avoid transmitting HIV to the baby.

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