Getting pregnant when HIV positive can be a tough decision to make if you already know your status. If you don't, or if you have an unplanned pregnancy, there are ways to ensure your baby will be protected from contracting HIV.

Screening for HIV

All pregnant women are usually screened at the first prenatal visit for the presence of the HIV antibody. The initial test for HIV is called an "ELISA" test.

Negative ELISA tests do not always rule out HIV infection. If you have just recently become infected, then it can take up to several weeks for the test to become positive. During this "window" period, antibodies usually cannot be measured for many weeks.

A positive result on the ELISA screening test does not mean that there is an HIV infection. Certain conditions may lead to a false positive result. These conditions associated with a false positive ELISA include:

  • Lyme disease
  • Syphilis
  • Lupus

A positive ELISA test is always followed by a Western blot test. A positive Western blot confirms an HIV infection. A negative Western blot test means the ELISA test was a false positive test. The Western blot test can also be unclear, in which case more testing is done.

How likely is transmission?

If you are pregnant and HIV positive and you are not taking preventative drugs, there is a 20% to 45% chance that your baby will contract the disease during birth or breastfeeding. But with preventative drugs in place, you can lower the risk of passing the disease onto your baby to about 2%. Even when limited resources are available, just one or two doses of this medicine can lower the risk of passing it on.

Planning for pregnancy

If you are HIV positive and want to become pregnant, it is important to plan ahead. A doctor is the best resource for tailored information, considerations with HIV and pregnancy, the stage of the disease, what (if any) drug or other medical interventions are needed, and how to adjust the treatments that are already being given to the mother.

If you want to keep your partner safe when conceiving a child, a system such as artificial insemination is recommended. The process prevents a man from contracting HIV, but has no difference when it comes to the health of the baby. Alternatively, if it is a man who is HIV positive, then the only way to prevent transmission to the fetus is to go through sperm washing. This separates the sperm from the fluid. It is then tested and used with in vitro fertilization. This process, however, is not available in many places.

Even if a couple with one or both partners HIV positive wants to get pregnant, unprotected sex is not recommended because of the risk of re-infecting one partner with a different strain of HIV. If unprotected sex does occur, it should be when those infected are on antiretroviral medications and only during the time of ovulation.

Are HIV drugs safe during pregnancy?

It is normal to be cautious and worried about taking drugs during pregnancy. It is usually wise to avoid drugs during pregnancy, but if you have HIV, ARV drugs are usually recommended. There have been thousands of healthy babies born to mothers who were on ARV drugs during their pregnancy. This is the best way to protect your baby from contracting the disease. But as with all drugs, there is no guarantee that it will not affect every baby. You may be advised to wait on the ARV drugs until after the first trimester of pregnancy if you were not already taking them before conception.

If you have any questions or concerns, seek advice from a medical professional. They can answer your questions about medications and make sure you and your baby are protected during your pregnancy.

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