Reducing the risk of mother to child HIV transmission during pregnancy and childbirth

In the United States, reducing the risk of transmitting HIV from mother to child during pregnancy and/or childbirth has been a success story. With the use of anti-viral therapy during pregnancy, the rate of transmission for HIV-positive women to their infants, has decreased overall from 25% to less than 2%.

It is recommended that all pregnant women who do not know their HIV status have a HIV test as early as possible in the pregnancy. If this test does not show the woman is HIV-positive, but she is engaged in high risk activities, the test should be repeated during the pregnancy, preferably 3 months after the lost known high risk activity.

If a woman is HIV-positive, receiving anti-viral treatment for HIV will reduce the risk of transmission to 2% or less. Treatment will include anti-retroviral medication during the pregnancy and labor and delivery. The risk of transmission increases if a women has a high viral load (the amount of virus present in the body) or from longer delivery times, so a physician may decide that a cesarean section is the preferred delivery method, but this is not always necessary.

After birth, additional steps are taken to reduce the risk of HIV infection for the infant. Anti-viral therapy is given to the infant for four to six weeks. Breast milk contains HIV and it is possible for a HIV-positive woman to transmit HIV to her baby through breast feeding. It is generally not recommended that HIV-positive women living in the United States breast feed their babies. Talk to your physician to determine the best alternative to eliminate this risk.

Determining the HIV status of an infant takes time and requires repeat testing. Standard HIV tests look for the presence of HIV antibodies. Because infants of HIV-positive mothers have the mother’s HIV antibodies, they will automatically test “positive” after birth. It can take up to 18 months for an infant to clear these antibodies and receive an accurate HIV antibody test. Because of this issue, physicians recommend using a testing method that looks for the presence of the actual HIV virus and can give a definitive result in within a few months of birth.

If you are HIV-positive and suspect you are pregnant, see your health care provider as soon as possible. It is important for the health of you and your baby that you thoroughly discuss HIV treatment options with your provider.

If you are uncertain of your HIV status and are pregnant, it is recommended that you get an HIV test. The risk of transmitting HIV to your baby is virtually eliminated through proper treatment. Knowing your status allows you to make the best decisions to protect your health and the health of your baby.

Last Updated: Tuesday, August 18, 2009
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