Preventing Mother-to-Child Transmission of HIV (Developed)
Preventing Mother-to-Child Transmission of
HIV/AIDS in Developed Countries: What You Need to Know Hi, my name is Dr. Becky Kuhn. I’m a physician who
specializes in HIV/AIDS. Welcome to “Preventing Mother-to-Child Transmission of
HIV/AIDS in Developed Countries: What You Need to Know.”
If a woman is HIV positive and becomes pregnant, there is a risk that her child will
contract HIV during the pregnancy, more commonly during childbirth or while
breastfeeding. If an HIV positive woman takes no steps to protect her child from HIV
and does not breastfeed, there is a 15-30% chance that her child will contract HIV. If
she also breastfeeds, the risk of transmission increases to 20-45%.
However, if an HIV positive woman follows her doctor’s instructions, which will
include use of appropriate antiretroviral medications, it is possible to reduce the
risk of the child contracting HIV. If you are pregnant
or thinking about having a baby, the information in this video could save your
child’s life, so please watch the whole video and listen carefully.
This video is intended for women who are in developed nations such as the United
States and Western Europe. Women in these countries who are HIV positive can
usually get access to medical treatment they need to decrease mother-to-child
transmission of HIV. There is a separate video on this site for women in developing
countries who may not have access to health care services or medications.
See a Doctor If you know you are pregnant or are thinking
about having a baby, see a doctor. They can give you health advice that will maximize
your chances for a safe pregnancy and a healthy baby whether or not you have HIV.
Get Tested for HIV The next step to protecting your baby from
HIV/AIDS is to get tested and find out if you are HIV positive. You may be HIV positive
and not know it. The U.S. Public Health Service recommends that all pregnant
women be tested for HIV and even that HIV testing become part of a routine medical
check-up. Even if you are already well along in your
pregnancy or nearing delivery, you should still be tested for HIV, if you had not been
tested before. The sooner you are tested, the
better your chances of protecting your child from HIV, so don’t delay. You can’t
protect your child if you don’t know your HIV status.
In most countries this test is available free of charge.
If You’re HIV Negative, Stay That Way If you are pregnant and have tested HIV negative,
you can reduce your risk of becoming positive during your pregnancy by
staying mutually faithful to one partner or using condoms. Pregnant women need to be just
as careful as anyone else to avoid contracting HIV.
If You’re HIV Positive, See a Doctor Right Away
If you are HIV positive, do not despair. With modern antiretroviral medications, it is
now possible for HIV positive individuals to remain healthy for years, even decades.
If you are pregnant and follow your doctor’s
instructions, you can also reduce your child’s chance of contracting HIV.
The rest of this video will tell you about some of the steps your doctor may recommend
to protect your infant if you are pregnant. Remember, different people have different
needs, and watching a video is no substitute for seeing a doctor and getting personal
advice that’s right for you. Antiretroviral Medications (ARVs)
HIV is a virus. Antiretroviral Medications known as ARVs can interfere with the
virus’s ability to reproduce and infect new cells within your body. Your doctor will
suggest using ARVs to protect your baby. Starting ARVs Immediately
Your doctor may recommend that you start taking antiretroviral medications
immediately if you are not already on them. Your doctor is especially likely to
recommend this if you are showing symptoms of clinical AIDS, your T cell count
(immune cells) is low, or the amount of virus in your body is high. Going on ARVs can
improve your own health as well as reducing the chance that your child will contract
HIV during pregnancy, or, more commonly, during childbirth. If you are already on
ARVs, your doctor will keep you on them, except for Sustiva, which has been shown to
cause problems for a developing fetus. If your doctor prescribes ARVs, it’s extremely
important to take every dose of the medications on schedule. A separate video on this
web site called “Prevention for Positives” explains more about why taking every dose
of ARV medications on schedule is so important. Starting ARVs After the First Trimester
Even if your doctor doesn’t recommend that you start ARVs immediately, they will
recommend going on ARVs after the first trimester. The reason for this is to minimize
the effects of ARVs on a fetus while they are in the most critical early development
stages in the womb. Many studies have been done on the safety of ARVs during
pregnancy, so protect the health of your baby by taking ARVs according to your
doctor’s instructions. Scheduled Caesarian Section
There is evidence that the risk of mother-to-child HIV transmission may be lower if the
child is delivered via a scheduled Caesarian section rather than by a natural vaginal
delivery. Additionally, if a woman is on ARV and her viral load Ð or amount of virus
in the body is less than 1,000, vaginal delivery is as low a risk as Caesarian section Ð
approximately 1%. Of course, Caesarian sections carry their own increased risks of
infection for the mother and possible respiratory complications for the child. Talk with
your doctor as early in your pregnancy as possible about what the best approach may
be for your situation.
Intravenous (IV) ARVs During Labor and Delivery In standard medical practice, every HIV positive
woman should receive IV AZT during delivery, once her water has broken.
ARVs for the Child After Delivery It is possible to further reduce the risk
that the baby will become HIV positive by giving the infant oral antiretroviral medications
after delivery. The U.S. Public Health Service recommends that babies born to HIV
positive mothers be given AZT in liquid form every 6 hours for six weeks after birth
and it’s critical that you give the child every dose of medication on schedule.
Feeding the Child Formula Instead of Breastfeeding If the mother is HIV positive and breastfeeds
her baby, this increases the risk of mother-to-child HIV transmission. As a result,
if the mother is HIV positive, “The CDC recommends that in areas where safe drinking
water and infant formula are available (such as the United States), [HIV positive]
women should not breastfeed in order to avoid transmission of HIV to their infants
through breast milk.” Testing the Baby for HIV
All babies born to HIV positive mothers should be tested to determine whether they are
HIV positive. “Babies born to HIV positive mothers are tested for HIV differently than
adults. Adults are tested by looking for antibodies to HIV in their blood. A newly born
infant keeps antibodies from its mother, including antibodies to HIV, for many months
after birth. Therefore, an antibody test given before the baby is 1 year old may be
positive even if the baby does NOT have HIV infection. For the first year, babies are
tested for HIV directly, and not by looking for antibodies to HIV. When babies are
more than 1 year old, they no longer have their mother’s antibodies and can be tested
for HIV using the antibody test. If after 1 year, the baby tests negative, they are
considered HIV negative. If Your Child is HIV Positive
If your child turns out to be HIV positive, do not despair. Talk with your doctor about
what treatments are right for your child. With appropriate treatment, HIV positive
infants may be able to live a healthy life. There are already college students today who
were born as HIV positive infants. If your child is HIV positive, talk with your doctor
about how to keep them healthy and make sure to follow the doctor’s instructions
exactly. Important Things to Remember
Let’s close by reviewing some of the most important lessons from this video.
¥ If you are suspect you are pregnant or want to become pregnant, see a doctor and
get tested to determine if you are HIV positive.
If you are pregnant and HIV positive, there are many things you can do to reduce the
risk of mother-to-child transmission. It’s important that you talk to your doctor about
what to do to keep the risk as low as possible and follow the doctor’s instructions
exactly. For AIDSvideos.org, this is Dr. Becky Kuhn.