3.8. HIV infection and pregnancy
One of the HIV-transmission routes is the transmission of the virus from mother to child. HIV can be transmitted from mother to child in both the prenatal period (through defects in placental barrier), and during birth, when a child is exposed to maternal blood (vertical transmission) or during breastfeeding. In the case of prevention and appropriate treatment of the mother, the risk of transmitting HIV to a child is reduced to zero.
Now scientists know how to prevent HIV transmission from mother to child. Women with HIV give birth to healthy children without the HIV infection. According to the World Health Organization, the risk of mother-to-child HIV transmission without receiving therapy is 20-45%. If preventive measures are taken, the risk drops to 1%, and in some countries (Cuba, Thailand, Armenia, etc.) there are no newborns with HIV infection.
Many studies show that HIV infection may be effectively treated during pregnancy provided that the selected medications do not have harmful effects on the fetus and the pregnant woman's body. In addition, antiretroviral therapy reduces the viral load thus reducing the risk of HIV infection of an unborn baby to almost zero.
People with positive HIV status have the same ability to have their own children as people with HIV-negative status. Some women have pregnancies while taking antiretroviral therapy, the remainder detect HIV infection during pregnancy. Pregnant women are advised to do an HIV test.
During pregnancy, women with positive HIV status should contact the HIV prevention center. Specialists will be able to advice on further observation and examination during pregnancy and, when necessary, provide medications to prevent transmission of HIV from mother to child.
Prevention, which stops HIV transmission from mother to child, consists of several stages:
- Prescription of antiretrovirals (ARVs) to a pregnant woman. Therapy should be started as soon as possible after the discovery of HIV infection;
- Administration of ARTs at the time of delivery to reduce the risk of transmission, because, when passing through the birth canal, a child may come into contact with the mother’s blood, which dramatically increases the risk of infection. In some cases, it is recommended to perform a caesarean section;
- Prescription of ARTs to a newborn immediately after birth.
It is impossible to determine immediately after delivery whether a child has HIV or not. All of the tests for HIV infection can be positive in a child until one and a half years old, because maternal antibodies are found in his blood and are destroyed gradually.
Breastfeeding is one of the ways of HIV transmission and increases the risk of a child getting an infection. Doctors recommend against breastfeeding to eliminate this risk.