HIV

What do I need to know about pregnancy and HIV infection?

If you are a woman living with HIV and you are pregnant or considering having children, congratulations! Medications to treat HIV allow women with HIV to live longer, healthier lives and deliver healthy, HIV-negative babies. Below, you'll find a list of common questions that women ask about pregnancy and HIV.

Q: I am a woman with HIV and am considering having children. Should I take HIV medicines?

Yes. In general, all persons with HIV should start antiretroviral therapy (also known as "ART") early, and as soon as possible. If you are a woman who is trying to get pregnant or plans to become pregnant soon, it is even more important to be on ART. These medications will help your body defend itself from HIV-related infections. Taking the medications every day and achieving an undetectable HIV viral load will also protect your partners from getting HIV. And, very importantly, taking ART every day will greatly lower your baby's risk of becoming infected by HIV.

Women with HIV should try to achieve an undetectable viral load before they become pregnant. If a woman with HIV chooses not to take HIV medicines, the chance of the baby being born with HIV is 1 in 4. But with effective treatment and an undetectable viral load, the chance of a baby being born with HIV is only 0.4%, or less!

Q: As a pregnant woman with HIV, what HIV medicines should I be taking?

It is very important to see a provider who has experience treating pregnant women with HIV. Most HIV medicines that are used for non-pregnant women can also be used for pregnant women, but some should be avoided or dosed differently.

When you and your provider choose your HIV medicines, the decision will be based on many factors. These include whether your HIV virus has resistance to any of the medications, which ones you've taken in the past, what side effects you or your baby may experience during pregnancy and after birth, and how easy it will be for you to take the medicines every day.

Q: I am already taking HIV medicines and I want to get pregnant. Do I need to switch my medicines?

If your HIV medicines are working and you have an undetectable viral load, you don't usually need to switch when planning for a pregnancy. However, there are a few HIV medications that your provider may want you to avoid because of possible effects on the fetus. Discuss this with your provider before you become pregnant.

A woman's body undergoes many changes during pregnancy. These changes can affect how her body reacts to HIV medications. During pregnancy, a woman's body sometimes becomes more efficient at removing HIV medicines from the bloodstream. Depending on the medicines you are taking, your provider may have to adjust the dosages to ensure that you and the baby are getting a sufficient amount.

Q: After my baby is born, will he or she have to take HIV medications?

When a pregnant woman with HIV takes effective ART (HIV medications) during her pregnancy, the chances of her baby getting HIV are extremely low. To reduce the risk even more, it is recommended that all infants who are born to mothers with HIV take medications for a short time. If you took ART during your pregnancy and had an undetectable viral load, your baby will receive liquid zidovudine (AZT, Retrovir^®) for 4-6 weeks. If you didn't have an undetectable viral load during pregnancy, your baby may need medicine for a longer period of time.

Q: Why can't I breastfeed my baby?

Many mothers look forward to breastfeeding their babies. However HIV can be passed through breast milk. If you breastfeed your child, you run the risk of your baby getting HIV. It is recommended that mothers with HIV do not breastfeed their babies and that they use formula instead. If you would like more information on the possible risks and benefits of breastfeeding, consult with a pediatrician or obstetrician who is an expert in HIV infection, ideally before delivery.