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HIV & Pregnancy

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With the availability of HIV testing, the ability to provide anti-retroviral therapy (ART) to a pregnant woman during pregnancy and provide treatment to an infant after childbirth, the risk of mother-to-child transmission of HIV infection is low.

That being said, any woman who is HIV positive should consult her family physician, her HIV doctor and her gynaecologist before and during her pregnancy. Taking the recommended precautions prior to and following conception will greatly lower the risk that HIV will be passed from mother to baby.

HIV Testing Before and During Pregnancy

Many women are HIV positive but don’t know it. So if you’re thinking of having a child, planning a pregnancy or are already pregnant, you should get tested for HIV.

A woman must request an HIV test in addition to standard prenatal blood tests. HIV tests are NOT included as part of standard prenatal tests. If you don’t request an HIV test at the same time as your standard prenatal blood tests and your doctor does not suggest an HIV test, then an HIV test won’t be done.

It’s a good idea to be retested for HIV before each pregnancy even if your previous results came back negative. Many healthcare providers can order a confidential HIV blood test at any time at a woman’s request.

HIV-Positive Pregnancies

Reducing the Chance of Mother-To-Baby Infection

An HIV positive mother can pass the HIV infection to her infant during pregnancy (before birth), during delivery (the most common way babies get infected) or through breastfeeding.

The risk of mother’s transmitting the HIV virus to her unborn baby is roughly 25%.

Without prevention, some babies born to HIV-positive mothers will contract HIV. .

Taking Antiretroviral Therapy (ART) During Pregnancy

Antiretroviral therapy reduces the risk of HIV transmission during pregnancy and at birth. If mother living with HIV takes a combination of antiretroviral therapies during pregnancy and delivery, and the newborn also receives these drugs, the chance of HIV transmission drops (from mother to baby) to about 1%.

HIV-Exposed Newborns

Choosing a Delivery Method

Doctors can reduce the risk of mother-to-baby transmission by shortening a woman’s delivery time or by delivering the baby by caesarean section.

Whether you deliver your baby by caesarean-section or vaginally depends on how much of the virus is circulating in your blood (“viral load”) when you go into labour.

If you’re pregnant and HIV positive, trust your health care team. They will carefully consider your particular situation and provide advice about which delivery method is best for you and your baby. 

Testing Newborns for HIV

Babies infected with HIV don’t look or act any different from other newborns.

The only way to tell if a newborn baby is HIV positive is through three blood tests; the first test is done within the first few days after the baby is born; the second at one month of age; and the third between two and four months of age.

If all three tests are negative for HIV, then the baby doesn’t have HIV. If any of the three tests are positive, then the baby will be retested.

Antiretroviral Therapy and Routine Vaccinations

Antiretroviral Therapy for Newborns

A newborn whose mother is living with HIV will be given an antiretroviral therapy regimen that is taken from birth until six weeks of age. This medication will help to protect against HIV. A second drug will then be given to help prevent pneumonia that often occurs in HIV positive babies.

Routine Immunizations

Babies receiving HIV antiretroviral drugs can and should receive the same routine immunizations on the same schedule as other HIV negative infants.

* Source: The Hospital For Sick Children (MotherRisk)

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