In this article:
What Is HIV?
HIV is an acronym for the human immunodeficiency virus. The retrovirus destroys the immune system by attacking CD4 cells. If HIV infection is not treated, it causes acquired immunodeficiency syndrome (AIDS), where the immune system is severely weakened.How Does HIV Affect the Body and Your Pregnancy?
When HIV infection is present in a pregnant woman, it means that the immune system of the pregnant woman is weakened, so she becomes vulnerable to different infections during pregnancy and childbirth.The good news is that modern science and medical treatments, such as ART (antiretroviral therapy), have reduced this risk considerably, to almost no risk. ART is a strong regimen of treatments to limit HIV transmission to your baby during pregnancy.
Risks of Mother-to-Child Transmission
According to the WHO, there is up to a 15 % to 45 % chance of transmission of HIV from the mother to her child during pregnancy, delivery, and breastfeeding without any intervention. However, with the implementation of the complete prevention program consisting of ART therapy for the mother, planned delivery, and ART for the child, the risks drop.Mother-to-child transmission takes place in three different ways:
- During pregnancy, through the placenta.
- During labour and delivery, due to exposure to maternal blood and fluid.
- Breastfeeding after delivery.
Pregnancy Symptoms and Health Issues
Most HIV-positive women do not have any symptoms, especially when their virus is under control. But there are several health issues to consider when pregnant, including increased risk of developing infections such as thrush, urinary infections, or respiratory issues, along with fatigue that is more intense compared to non-HIV-positive pregnancies.ART side effects, including nausea, headaches, and insomnia, among others, may overlap with pregnancy symptoms; thus, it is important to mention them to the HIV doctors rather than managing on our own.
Role of Early HIV Testing in Pregnant Women
It is advised that HIV testing should be done by all pregnant women during their first prenatal visit. Early testing can ensure that ART is started as soon as possible if required, providing sufficient time for the medicine to act upon the virus before delivery. Screening for HIV infection among pregnant women is carried out within the antenatal program for PPTCT (Prevention of Parent to Child Transmission). A woman who has a negative result initially due to risks present may be advised to undergo a repeat test after some time.Monitoring Mother and Child During Pregnancy
Pregnant women living with HIV require special antenatal care that includes close monitoring of the viral load and CD4 count in addition to regular pregnancy monitoring. Monitoring includes the following steps:- Testing of viral load every month or every three months during pregnancy.
- Monitoring of CD4 count to determine immune system status.
- Growth scanning to monitor fetal growth.
- Screening for sexually transmitted diseases that increase the risk of transmitting HIV.
- Planning of delivery depending on the viral load at 36 weeks. Delivery through the vagina is considered safe when there is no detectable viral load.
- A newborn baby requires taking a short-term regimen of ART and HIV testing at certain intervals in the first weeks of life.
When to Contact a Doctor
Being in constant support with your medical team during pregnancy is perhaps the best thing you can do for yourself as an HIV-positive mother. Get in touch immediately if any of the following circumstances occur:- If you have missed an ART dose and do not know how to cope with it.
- Side effects from your drugs are interfering with your eating, sleeping, or functioning.
- If you suspect that you have an infection, fever, abnormal discharge, or respiratory signs.
- If the movements of the baby change or become less frequent than before.
- If you suffer from emotional problems that hinder you from living your regular life.
- If you experience any symptoms that seem to be associated with your HIV infection or medications.
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FAQs on HIV During Pregnancy: How It Can Affect You and Your Baby
- Is it okay for me to breastfeed if I have HIV?
Yes, if you are living with HIV and taking antiretroviral therapy (ART) consistently, you can breastfeed your child exclusively for the first 6 months, then add complementary foods until 12 months or beyond. ART effectively prevents HIV transmission through breast milk. - Will my baby need to take any HIV drugs after birth?
Yes, all newborns born to HIV-infected mothers are given antiretroviral drugs to protect them from being infected with the virus, which lasts between 4 and 6 weeks. - Does HIV mean that I must have a caesarean delivery?
Not necessarily. If a woman's viral load is undetectable after 36 weeks of pregnancy, a vaginal delivery is possible. If the viral load is detectable around the time of delivery, a caesarean delivery is advised since it exposes the baby to less maternal blood.