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Perinatal HIV, also known as mother-to-child transmission, can happen at any time during pregnancy, labor, delivery, and breastfeeding. CDC recommends that all women who are pregnant or planning to get pregnant take an HIV test as early as possible before and during every pregnancy. This is because the earlier HIV is diagnosed and treated, the more effective HIV medicines, called antiretroviral treatment (ART), will be at preventing transmission and improving the health outcomes of both mother and child.
Advances in HIV research, prevention, and treatment have made it possible for many women living with HIV to give birth without transmitting the virus to their babies. HIV infections through perinatal transmission have declined by more than 90% since the early 1990s, while the number of HIV-infected women giving birth has increased. Today, if a woman takes HIV medicines exactly as prescribed throughout pregnancy, labor, and delivery, and provides HIV medicines to her baby for 4-6 weeks, the risk of transmitting HIV can be 1% or less. In some cases, a Cesarean delivery can also prevent HIV transmission. After delivery, a mother can prevent transmitting HIV to her baby by not breastfeeding and not pre-chewing her baby's food.
Women who are HIV-negative but have an HIV-positive partner should talk to their doctor about taking HIV medicines daily, called pre-exposure prophylaxis (PrEP), to protect themselves while trying to get pregnant, and to protect themselves and their baby during pregnancy and while breastfeeding.
Fact Sheets provide pregnant women with a list and description of recommendations for all pregnant women including the HIV test.
Tell your doctor you want to get pregnant. Your doctor can help you decide if you need to change your treatments to lower your viral load, to help you get pregnant without passing HIV to your partner, and to prevent you from passing the virus to your baby. He or she will also help you get as healthy as possible before you get pregnant to improve your chances of a healthy pregnancy and baby. Don't stop using condoms for STI prevention and another method of birth control for pregnancy prevention until your doctor says you are healthy enough to start trying.
Get prenatal care. Prenatal care is the care you receive from your doctor while you are pregnant. You need to work closely with your doctor throughout your pregnancy to monitor your treatment, your health, and your baby's health.
Start HIV treatment. You can start treatment before pregnancy to lower the risk of passing HIV to your baby. If you are already on treatment, do not stop, but do see your doctor right away. Some HIV drugs should not be used while you're pregnant. For other drugs, you may need a different dosage.
Manage side effects. Side effects from HIV medicines can be especially challenging during pregnancy, but it is still important that you take your medicine as directed by your doctor. Talk to your doctor about any side effects you have and about ways to manage them.
Do not breastfeed. You can pass the virus to your baby through your breastmilk even if you are taking medicine. The best way to avoid passing HIV to your baby is to feed your infant formula instead of breastfeeding.
Make sure your baby is tested for HIV right after birth. You should choose a doctor or clinic experienced in caring for babies exposed to HIV. They will tell you what follow-up tests your baby will need, and when. Talk to your doctor about whether your baby may benefit from starting treatment right away.
Ask your pediatric HIV specialist if your baby might benefit from anti-HIV medicines before you know if your baby is HIV-positive or HIV-negative. Research has shown that giving combination HIV drugs to newborns is better at preventing HIV than taking AZT (azidothymidine, an antiretroviral medicine) alone.
Indiana Code (CODE 16-41-6) requires that all pregnant women be tested for HIV testing as a component of routine prenatal care unless they refuse in writing. The Code is supported by the Centers for Disease Control (CDC) Guidelines which recommend that all women who are pregnant, or planning a pregnancy, be tested for HIV regardless of their risk factors or the HIV prevalence rates where they live. As the guidelines indicate, consent should not be a prerequisite for nor a barrier to testing. Women who do not want the HIV screening test can opt out with written refusal. This approach is critical to our public health initiative to prevent mother to baby HIV transmission.
Please consider your health and the health of your baby. Have the HIV test, even if you feel you are not at risk. It is possible to have HIV, the virus that causes AIDS, and not show signs or symptoms for many years. The only way to be sure that you do not have HIV is to have a test. If you feel you may have put yourself at risk right before or during your pregnancy, ask your doctor to repeat the HIV test during the third trimester. If you refuse an HIV test during pregnancy, a physician can order HIV testing on your baby if it is believed to be necessary for your baby's health. The physician who orders the test must tell the newborn's mother about the test, the purpose of the test, the risks and benefits of the test, and the test results.
Proper diagnosis and treatment can improve the health of the mother and dramatically reduce the transmission of HIV from mother to infant from 25-30% down to <2%.
New cases of HIV (moms) and Delivery of HIV exposed infants must be reported to Indiana State Department of Health. Forms can be found at HIV/AIDS Confidential Case Reporting Forms http://www.in.gov/isdh/17764.htm
This is the number of babies infected with HIV in Indiana during the three years prior to start of One Test Two Lives: Prevent HIV Indiana.
One Test, Two Lives offers health care providers information and resources to encourage them to test pregnant women for HIV infection and help reduce the number of infants born with HIV.
Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States (Updated October 26, 2016)