Getting pregnant when a woman is HIV positive can be a tough decision to make if the woman already knows her status. If she doesn’t, or it is an unplanned pregnancy, there are still ways that the baby can be protected from contracting HIV from the mother.
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
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 an HIV positive woman is pregnant and not taking preventative drugs, there is a 20% to 45% chance of the baby contracting the disease during pregnancy, through the labor process, or breastfeeding. But with preventative drugs in place, a mother can lower the risk of passing the disease onto her 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 a woman who is HIV positive wants to become pregnant, there are good ways to plan ahead for this instance. A doctor is the best resource for information tailored to any specific woman, but some considerations with HIV and pregnancy are 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 a woman wants to keep her partner safe when conceiving a child, a system such as artificial insemination is recommended. The process prevents the man from contracting HIV, but has no difference when it comes to the health of the baby. Alternatively, if it is the 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 for Pregnancy?
Many women are concerned about taking drugs during their pregnancy. It is usually wise to avoid drugs during pregnancy, but for those with HIV, ARV drugs are usually recommended. There have been thousands of healthy babies born to mothers on ARV drugs during the pregnancy. And this is the best way to protect the baby from contracting the disease. But as with all drugs, there is no guarantee that it will not affect every baby. Some women many be advised to wait on the ARV drugs until after the first trimester of pregnancy if she was not already taking them before conception.
With any questions or concerns, a woman who is pregnant and HIV positive should seek the advice or a medical professional. They will be able to advise the woman is all types of situations with medications, when to take them, and how else to protect themselves and their baby from any harm during the pregnancy.