Woman managing HIV in pregnancy

Managing HIV In Pregnancy: What You Need To Know

Written on August 11, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Globally, 1.2 million pregnant women had HIV in 2022, of which an estimated 82% received antiretroviral drugs to prevent mother-to-child transmission. At the end of 2022, 1.5 million children were living with HIV globally, down from 2.5 million in 2010.[1]

The statistics are encouraging in that we are seeing a reduction in HIV transmission during pregnancy, but until that number is zero, we cannot afford to become complacent.

The March of Dimes provides the following answers to frequently asked questions about HIV mother-infant transmission.

If You Have HIV That’s Not Treated, How Can You Pass It To Your Baby?

Before birth, it is passed through the placenta. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord.

During labor and birth, it is passed through contact with the mother’s blood and vaginal fluids. When you go into labor, your amniotic sac breaks, which increases your baby’s risk of getting infected. The amniotic sac is the sac (bag) inside the uterus that holds a growing baby. It’s filled with amniotic fluid. Most babies who get HIV from their moms get infected around the time of birth.

After birth, it is passed through breast milk. If you have HIV, don’t breastfeed your baby.

How Can You Help Protect Your Baby From HIV During Pregnancy?

Get tested and treated for HIV. If you have HIV, getting treatment before and during pregnancy can usually prevent infection in your baby. If you take HIV medicines throughout pregnancy, labor, and birth, and give your baby HIV medicines for 4 to 6 weeks after birth, the risk of passing HIV to your baby can be 1 in 100 (1%) or less.

The CDC recommends that all women who are pregnant or planning to get pregnant get an HIV test as early as possible before and during every pregnancy.

The earlier HIV is diagnosed and treated, the better HIV medicines work to protect your health and prevent infection in your baby. HIV is treated with a combination of medicines called antiretroviral treatment (also called ART). ART can help reduce the amount of HIV in your body (also called viral load) and keep your immune system stronger. Taking ART the right way every day can keep your viral load low and help reduce the risk of passing HIV to your baby during pregnancy.

What Do You Do If You’re Pregnant And Have HIV?

The CDC recommends that you get tested as early as possible and again later in pregnancy if you do things that put you at high risk for HIV, like having more than one sex partner or you share drug needles. If you haven’t had an HIV test during pregnancy, you can get a quick test during labor and birth. If this test shows you have HIV, you can still get treatment to help protect your baby from infection.

Private STD consultations

During pregnancy, your provider checks your viral load and CD4 cell count throughout pregnancy. If you have a high viral load or a low CD4 count, you’re more likely to get sick and pass HIV to your baby. Even if you have a low viral load, you can still pass HIV to your baby. If you’re being treated for HIV during pregnancy, here are some things you can do to help keep your baby safe from infection:

  • Take your HIV medicine exactly as your provider says.
  • If you’re thinking about having certain prenatal tests, like amniocentesis (also called amnio) or chorionic villus sampling (also called CVS), ask your provider about the risk to your baby. Amnio and CVS are used to diagnose certain birth defects and genetic conditions in your baby. Having these tests may increase your baby’s risk for infection.
  • Talk to your provider about cesarean birth (also called C-section). If you have high or unknown levels of HIV in your body, a C-section can help reduce the chances of your baby getting infected. A C-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. If you have HIV and your CD4 cell count is low, your c-section incision (cut) may heal slowly and you’re more likely to get an infection. Your provider can give you medicine to help prevent infection during surgery.
  • Be sure that your baby gets treated for HIV after birth. This helps reduce your baby’s chances of getting infected with HIV during birth. Your baby gets tested for HIV for a few months after birth. If she has HIV, early treatment is important because HIV can advance faster in children than adults. Early treatment can help children with HIV live longer, healthier lives.
  • Don’t breastfeed your baby.
  • Once your baby’s eating solid food, don’t chew it before giving it to them.[2]

How Can Everlywell Help?

Here are a few ways that Everlywell can help if you have HIV in pregnancy.

HIV Testing Kit

Everlywell offers a discreet at-home HIV testing kit. Early detection of HIV among pregnant women is extremely important, so this kit makes testing easy.

Virtual Visits

Everlywell offers STI consults in two hours or less. Think you may have been exposed to HIV? Connect with a clinician in less than two hours. Clinicians are available in select states Monday-Friday, 7 a.m.-6 p.m. CST (Age 18+).

Make Right-For-You Medical Decisions

STDs typically cause mild symptoms, but it is also possible to have an STD and feel no symptoms at all. Many STDs can be treated with medication and early detection is key.

Speak Privately To A Healthcare Provider

Your Virtual Care Visit will include a discreet 20- to 30-minute video call with a licensed board-certified nurse practitioner, where you can discuss your sexual health concerns and get questions answered.

Discuss A Care Plan For Your STD Or STI Symptoms

Your clinician will provide personalized recommendations and next steps based on your symptoms and exposure history. This may include additional testing or prescription medication, if applicable.

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  1. Data on the HIV response. WHO. https://www.who.int/data/gho/data/themes/hiv-aids/data-on-the-hiv-aids-response. Accessed on August 3, 2023.
  2. HIV and Pregnancy. March of Dimes. https://www.marchofdimes.org/find-support/topics/pregnancy/hiv-and-pregnancy. Last Reviewed February 2018. Accessed on August 3, 2023.
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