Temporary Disabled. :) please Go back HIV and Pregnancy www.fgks.org » Address: [go: up one dir, main page] Include Form Remove Scripts Accept Cookies Show Images Show Referer Rotate13 Base64 Strip Meta Strip Title Session Cookies International HIV & AIDS charity DonateFundraising About Us Our Partners Help & Advice Contact Us Facebook Linked in Twitter Newsletter Copyright © AVERT skip to menu HIV and Pregnancy back to top Can HIV be transmitted from a mother to her baby? If a pregnant woman is infected with HIV, she can transmit the virus to her baby during pregnancy, labour and delivery, or breastfeeding. Without treatment, around 15-30 percent of babies born to HIV-infected women will become infected with HIV during pregnancy and delivery. A further 5-20 percent will become infected through breastfeeding.1 Modern drugs are highly effective at preventing mother-to-child transmission of HIV. When combined with other interventions, including formula feeding, a complete course of treatment can cut the risk of transmission to below 2 percent. Even where resources are limited, a single dose of medicine given to mother and baby can cut the risk in half. A woman who knows that she or her partner is HIV positive before she becomes pregnant can find out about interventions that may be able to protect herself, her partner or her baby from becoming infected with HIV. Doctors will be able to advise which interventions are best suited to her situation, and whether she should adjust any treatment she is already receiving if she is HIV positive. back to top Protection at conception An HIV positive woman with her baby. There are a number of interventions that can reduce the risk of HIV transmission between a couple when attempting to conceive a child. If a couple decide they want to conceive a child through unprotected sex, they should first seek advice on how to limit the risk to each other and to their baby. It is worth noting that someone is less likely to transmit HIV if they are receiving effective antiretroviral treatment, and also if neither they nor their partner has any other sexually transmitted infections. If the woman is HIV positive and the man is HIV negative An HIV positive woman and an HIV negative man can conceive without HIV transmission occurring by using artificial insemination (the process by which sperm is placed into a female's genital tract using artificial means rather than by natural sexual intercourse). This simple technique provides total protection for the man, but does nothing to reduce the risk of HIV transmission to the baby. If the man is HIV positive and the woman is HIV negative Sperm washing is a process used to prevent HIV transmission from an HIV positive man to his partner during conception. Sperm washing involves separating sperm cells from seminal fluid, testing these cells for HIV, then inserting the cells into the woman's womb (intrauterine insemination), or directly into the egg (in vitro fertilisation or intracytoplasmic sperm injection). Sperm washing is a very effective way to reduce the risk of HIV transmission during conception, but it is not widely available and can be difficult to access, even in well resourced countries. Alternatives to sperm washing have been researched, such as the method of using pre-exposure prophylaxis and timed intercourse when the HIV-positive male partner is taking antiretroviral drugs.2 If both man and woman are HIV positive When both partners are HIV positive, it might still be sensible for them not to engage in frequent unprotected sex, because there might be a small risk of one re-infecting the other with a different strain of HIV. back to top Protection during pregnancy, labour and breastfeeding The rest of this page is written from the point of view of a woman who knows she is HIV positive and pregnant. What drugs should I take and when should I take them? The drugs that can reduce the risk of HIV transmission from a mother to her baby are called antiretroviral (ARV) drugs. ARVs are the drugs that are taken by people living with HIV to prevent them from becoming ill. The most important time for an HIV positive pregnant woman to take ARVs to prevent her baby becoming infected is during labour. Depending on your particular circumstances it may be suggested that you take ARVs at other times as well. Deciding exactly which ARVs to take and when to take them can be quite difficult, because there is a need to balance a number of different things, including: Your health as an HIV positive pregnant woman Reducing the risk of HIV being passed from you to your baby The possibility of developing ARV side effects The possibility of drugs causing harm to your baby. There may also be a difference between which drugs you would ideally take and which ones it is actually possible for you to take, as there is considerable variation worldwide in the cost of ARVs and their availability. How do I know if I need treatment for my own health as an HIV positive woman? There are two tests, the CD4 test and the viral load test, that can help you and your doctor decide whether you need treatment for your own HIV infection. The CD4 test tells you how much HIV has weakened your immune system. The viral load test tells you how much HIV is in your blood. A pregnant HIV positive woman with a low viral load is less likely to have an HIV positive baby than a woman with a high viral load. Viral load tests may not be available to all women because of the cost. If you have a high CD4 count (exactly how high depends on your circumstances and which country you are in), this means that you still have a strong immune system. Your health care provider will probably suggest that you do not start taking drugs for your own HIV infection but will probably advise that you start taking drugs to prevent HIV transmission to your baby. I don’t need treatment for my own HIV infection. Which ARVs should I take to prevent my baby being infected? The choice of drugs you take will depend on a number of factors, including the country you are living in, which drugs are available in the area, and your own personal circumstances. While new WHO guidelines for PMTCT were released in 2010, it is yet to be seen whether these recommendations will be widely adopted. Until then, most women might be able to access recommended drug regimens from the 2006 guidelines which are described below. If available, you should take longer drug regimens starting earlier in pregnancy (for example, starting 28 weeks into pregnancy), rather than shorter regimens (for example, starting at 36 weeks of pregnancy). However, it will often be recommended that you delay starting treatment until after your first trimester (the first three months of pregnancy). If the drug Zidovudine (also known as AZT or ZDV) is available it will often be suggested that you take it, starting from 28 weeks of pregnancy (or as soon as possible thereafter). AZT is usually taken two or three times daily. An oral solution of zidovudine (AZT) During labour, if available, it will be recommended that you take a combination of ARVs. Combinations are more effective at lowering a woman’s viral load than single-drug regimens and so will be more effective in preventing transmission from mother-to-child. The World Health Organization (WHO) recommend taking AZT and lamivudine (3TC) as well as a single-dose of nevirapine during childbirth/delivery. Finally you will probably be given ARVs to take for a few weeks after the birth. WHO recommend taking AZT and 3TC for seven days after the birth. Taking this dual combination reduces the chance of developing resistance to the single-dose of nevirapine. WHO recommend giving the infant a single-dose of nevirapine immediately after the birth and AZT for one week. The nevirapine can be taken up to 72 hours after childbirth, but ideally as soon as possible. The decision whether or not to stop taking the ARVs after the prescribed regimen has finished depends upon your personal circumstances. Any decision should be made with your health care provider and should be based upon certain situations, such as CD4 count and clinical symptoms. If stopping the drugs, it is important that you stop them in a way that limits the amount of time there is just one drug in your body, as this will reduce the chances of developing drug resistance. I do need treatment for my own HIV infection. Which ARVs should I take to prevent my baby being infected, as well as to protect my own health? If you need ARVs for your own HIV infection, treatment should be started as soon as possible, even if you are still in the first trimester. Most ARVs do not have any major affects on the fetus during this time, although some drugs are more of a concern than others.3 It is therefore very important to discuss your treatment options with your health care provider. There are many different ARV drug combinations and those that are recommended are likely to be similar to those recommended if you were not pregnant. AZT will probably be part of the recommended regimen, due to its proven effect to reduce the risk of HIV transmission from mother to child. WHO guidelines recommend an initial regimen of AZT + 3TC + nevirapine (NVP). If there are very few drugs available where you live then you can take a single dose of NVP during labour to reduce the chances of your baby becoming infected, but you must not take it on its own at any other time. If you do you will increase the chances of drug resistance, and it will not work if you want to take it during labour to protect your baby. AVERT.org has more about single dose nevirapine in our mother to child transmission page. I’m already on antiretroviral drugs and now I've found out I'm pregnant - what should I do? If you have found out you are pregnant and are already taking ARVs you should seek advice from your health care provider as soon as possible. It is not recommended that you stop taking your ARVs or change your therapy before seeing your doctor. If you stop treatment suddenly during pregnancy then your viral load may increase, which can increase the risk of your baby becoming infected with HIV. Stopping treatment also needs to be done carefully in order to prevent the development of resistance. If your pregnancy is identified during the first trimester, the benefits and potential risks of taking treatment for both you and the infant will need to be considered. In particular, efavirenz is not recommended during the first trimester and can be substituted for NVP. If your pregnancy is identified after the first trimester then it will usually be recommended that you continue with your ARV treatment. back to top If I suddenly go into labour and I am not taking any ARVs, are there any drugs I can take to help my baby? There are several ARVs you can take during labour. The question of which ones to take and how long to take them for will depend upon drug availability. WHO recommended in 2006 a combination of single-dose nevirapine + AZT + 3TC for the woman during labour and delivery, followed by a seven-day tail of AZT and 3TC. Immediately after delivery, it is recommended that the baby is given a single-dose of nevirapine, followed by a course of AZT for four weeks. If drug availability is very limited, a single-dose of nevirapine for the mother during labour and a single-dose of nevirapine for the baby will probably be recommended as a minimum. back to top Is it really safe to take HIV drugs during pregnancy? Pregnant women are often advised not to take any medications during their pregnancy, so it can seem strange that HIV positive women are advised to take ARVs when pregnant. However, thousands of women have taken HIV drugs during pregnancy without it causing harm to their babies, and it has resulted in many babies being born HIV negative who might otherwise have been infected. It cannot be guaranteed that HIV drugs taken when a woman is pregnant will not harm her baby. If a woman is not already taking ARVs then as explained above she will probably be advised to wait until after the first trimester before starting treatment. There are specific recommendations and guidelines (see the sources at the end of the page), about certain antiretroviral drugs and which ones are more of a concern than others. The Antiretroviral Pregnancy Registry monitors the birth defects induced by ARVs. back to top What else can I do to prevent my baby becoming infected with HIV? Is a pre labour caesarean section (PLCS) better than a natural vaginal delivery? A caesarean section is an operation used to deliver a baby through its mother’s abdominal wall. When a mother is HIV positive it is done to protect the baby from direct contact with her blood and other bodily fluids. Research suggests that with many women now taking ARV combination therapy during pregnancy, having a caesarean isn’t a significant factor in preventing the transmission of HIV from mother to baby. Unless you are ill with HIV or have a detectable viral load it usually won’t be recommended by your health care provider, as having a caesarean does itself have some risks for the woman. One exception to this is if you are taking AZT on its own, when a PLCS may still be recommended. Should I breastfeed? HIV is found in breast milk, and if you breastfeed there is a significant chance of passing HIV to your baby. So if you have access to safe breast milk substitutes (formula) then you are advised to not breastfeed.4 If you live in a country where safe water isn’t available, the risk of life-threatening conditions from formula feeding may be higher than the risk from breastfeeding. Formula can also be too expensive to use regularly in some countries. If you are in this situation it is better to feed your baby breast milk alone. Mixed feeding is when a baby is fed with breast milk and other liquids such as formula, glucose water, gripe water or traditional medicine. It is now thought that there is a higher risk of a baby becoming HIV positive from mixed feeding than exclusive formula feeding alone or breastfeeding. Mixed feeding may damage the lining of the baby’s stomach and intestines making it easier for HIV in breast milk to infect the baby but when taking ARVs to prevent mother to child transmission, the risk is reduced and is currently recommended by the WHO. email print tweet more Where Next? AVERT.org has more about: Transmission and testing Mother-to-child transmission Breastfeeding and HIV HIV and nutrition Back to top Sign up to our Newsletter Donate References back to top De Cock et al (2000) 'Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice', JAMA 283(9), March Vernazza, P. et al, (2011, 23rd October) 'Preexposure prophylaxis and timed intercourse for HIV-discordant couples willing to conceive a child' AIDS 25(16) Public Health Service Task Force (2009) 'Recommendations for use of antiretroviral drugs in pregnant HIV-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States'. WHO/UNAIDS/UNICEF, 2010 'Infant feeding guidelines', Gevena Disclaimer & Privacy Policy back to top www.avert.org is an information resource to be used for educational purposes only. The information is not intended to serve as a substitute for professional medical advice and we recommend that all decisions about your treatment or products you wish to use should be discussed thoroughly and frankly with your doctor. english español back to content home pageHIV & AIDS Topics Living with HIVEpidemicGlobal EpidemicAIDS & HIV Around the WorldAIDS : What is AIDS? What causes AIDS?HIV & AIDS NewsHIV : The virus that causes AIDSReflections on the Epidemic World AIDS DayMoney for HIV/AIDSFunding for HIV and AIDS Money for HIV/AIDSPEPFARThe Global Fund How different people are affected by HIV and AIDS Men Who Have Sex with Men (MSM)Children orphaned by HIV and AIDSChildren, HIV and AIDSHIV/AIDS and Vulnerable Groups Prisons, Prisoners and HIV/AIDSTransgender People and HIV/AIDSWomen and HIV/AIDSIssuesHIV & Injecting Drug Users HIV & AIDS Stigma and DiscriminationHIV and AIDS IssuesHIV and Sex WorkHistoryHIV and AIDS HistoryAIDS TimelineHistory of AIDS Up to 1986History of AIDS: 1987-1992History of AIDS: 1993-1997History of AIDS: 1998-2002History of AIDS: 2003-2006History of AIDS: 2007 OnwardsAVERT History History of the HIV and AIDS Charity AVERT AVERT: Early 1990s to the start of the InternetAVERT: Overseas projects & developing AVERT.orgAVERT: Southern African projects and AVERT.orgAVERT: The First Five YearsLiving with HIVLiving with HIV and AIDSAm I going to die?Emotional Needs and SupportHIV and PregnancyLearning You Are HIV PositiveLiving with HIV StoriesWhat is living with HIV?PreventionOverview of HIV preventionHIV Prevention Around the WorldIntroduction to HIV PreventionPrevention of HIV transmission from mother to childHIV Transmission from Mother-to-childPreventing Mother-to-child Transmission (PMTCT) in PracticePreventing Mother-to-child Transmission of HIV WHO Guidelines for PMTCT & BreastfeedingPrevention of HIV transmission through bloodBlood Safety and HIVNeedle Exchange and Harm ReductionPrevention of HIV Transmission through BloodAIDS and sex educationAbstinence and Sex EducationHIV Prevention through Sex EducationHIV/AIDS Education and Young PeopleIntroduction to HIV and AIDS EducationLessons and Activity PlansSex Education That WorksPrevention of sexual transmission of HIVCircumcision & HIVCondoms: Effectiveness, History and AvailabilityHIV Prevention StrategiesPrevention of Sexual Transmission of HIVSex Workers and HIV PreventionThe Female CondomUsing Condoms, Condom Types and SizesHIV treatment as preventionHIV Treatment As PreventionHIV Treatment for PreventionPost-exposure Prophylaxis Pre-exposure ProphylaxisScienceHIV scienceA Cure for AIDSA World Free from HIVHIV and AIDS VaccineHIV Causes AIDSHIV Drugs, Vaccines and Animal TestingHIV Structure and Life CycleHIV Types, Subtypes Groups and StrainsMicrobicidesThe Origin of HIV and AIDS StatisticsWorldwide HIV & AIDS StatisticsUnderstanding HIV and AIDS StatisticsWorldwide HIV & AIDS StatisticsWorldwide HIV & AIDS Statistics CommentaryAmerican HIV & AIDS StatisticsUnited States of America HIV & AIDS Statistics Canadian HIV & AIDS StatisticsCanada AIDS Statistics by Year and AgeCanada HIV Statistics SummaryLatin American & Caribbean HIV & AIDS StatisticsCaribbean HIV & AIDS StatisticsLatin America HIV & AIDS StatisticsAfrican HIV & AIDS StatisticsSouth Africa HIV & AIDS StatisticsSub-Saharan Africa HIV & AIDS StatisticsAsian HIV & AIDS StatisticsIndia HIV & AIDS StatisticsSouth East Asia HIV & AIDS StatisticsAustralian HIV & AIDS StatisticsAustralia HIV & AIDS StatisticsEuropean HIV & AIDS StatisticsEuropean HIV and AIDS StatisticsUK HIV and AIDS Statistics Transmission & Testing HIV transmissionAIDS: Fear and AnxietyCan You Get HIV From. . . ?Criminal Transmission of HIVHIV & AIDS SymptomsHIV and BreastfeedingHIV Transmission Questions & AnswersHIV testingHIV TestingHIV Testing Frequently Asked QuestionsTreatment & Care HIV and AIDS treatmentHIV and AIDS TreatmentHIV and AIDS Treatment & CareHIV Treatment for ChildrenStarting, monitoring & switching HIV treatmentHIV and AIDS care HIV and AIDS CareHIV and AIDS Home Based CareHIV/AIDS and PainPalliative CareHIV and AIDS drugsAntiretroviral Drug Side EffectsAntiretroviral Drugs TableHIV and AIDS DrugsNew Antiretroviral DrugsTreatment accessAIDS, Drug Prices and Generic DrugsTreatment AccessUniversal Access to HIV/AIDS TreatmentAIDS-related infectionsHIV Opportunistic Infections: Prevention and TreatmentHIV/AIDS & related InfectionsStages of HIV InfectionTuberculosisOther treatment and careAlternative and Traditional Medicine for HIVHIV and NutritionHIV & AIDS Around The World AfricaThe HIV & AIDS epidemic in AfricaGay Men in Africa and HIV/AIDSHIV and AIDS in AfricaHIV and AIDS in Africa QuestionsThe Impact of HIV & AIDS in AfricaAfrican countriesHIV & AIDS in BotswanaHIV & AIDS in MalawiHIV and AIDS in KenyaHIV and AIDS in NigeriaHIV and AIDS in South AfricaHIV and AIDS in SwazilandHIV and AIDS in TanzaniaHIV and AIDS in UgandaHIV and AIDS in ZambiaHIV and AIDS in ZimbabweHIV and AIDS in LesothoHistory of HIV & AIDS in AfricaHistory of HIV & AIDS in AfricaHistory of HIV & AIDS in South AfricaTimeline of AIDS in AfricaAmericasHIV & AIDS in the United StatesHistory of HIV & AIDS in the United States of AmericaHIV & AIDS in the United States of AmericaHIV & AIDS Treatment in the United States of AmericaHIV and AIDS Among African AmericansHelp and advice for HIV and AIDS in AmericaUSA HIV & AIDS Help and AdviceHIV & AIDS in Latin America and the CaribbeanHIV & AIDS in BrazilHIV and AIDS in Latin AmericaHIV and AIDS in the CaribbeanAsia & EuropeHIV & AIDS in AsiaHIV & AIDS in ChinaHIV & AIDS in ThailandHIV and AIDS in AsiaOverview of HIV and AIDS in IndiaTimeline of AIDS in AsiaWho is Affected by HIV and AIDS in India?HIV & AIDS in EuropeHistory of HIV & AIDS in the UK 1981-1995History of HIV & AIDS in the UK 1996 OnwardsHIV and AIDS in Russia, Eastern Europe & Central AsiaHIV and AIDS in the UKHIV and AIDS in Western and Central EuropeHIV and AIDS Treatment in the UKHelp and advice in the UKHelp and Advice for HIV/AIDS in the UKWho Has to Pay for NHS Treatment in the UK?Sex, Sexuality & Relationships Gay & LesbianGay & LesbianAm I Gay? Are You Born Gay? Can You Stop Being Gay?Coming outGay and LesbianGay SexHomophobia, Prejudice & Attitudes to Gay Men & LesbiansHomosexual or Gay?How Many Gay People Are There?Lesbians, Bisexual Women and Safe SexYoung & GayBeing Gay at SchoolHIV, AIDS and Young Gay MenGay & LesbianAm I a Lesbian?Am I Gay?Young Gay Men & LesbiansResources & helpResources for people who are gay, lesbian or unsure'Young Gay Men Talking' booklet [PDF]STDsCommon STDsChlamydia Genital Warts HPVGonorrhea Hepatitis A, B & CHerpes STD PicturesSTIs or STDsSyphilisSTD StatisticsSTD Statistics WorldwideSTDs in AmericaSTDs in the UKSexInformation about sex Condoms & Spermicides questionsContraception questionsHow to Have SexOral SexPregnancy QuestionsSex QuestionsWorldwide Ages of ConsentYoung PeopleRelationships & SexAm I Ready for Sex?Being Gay, Sexuality and Attraction Having SexHaving Sex for the First TimeRelationships and FeelingsRelationships and Sex Your Body and PubertyPuberty and Boys' BodiesPuberty, Periods and Girls' BodiesYour Body, Puberty and Sexual Organs Having Safer SexAbout HIV/AIDS for Young PeopleAbout STIs & STDs for Young PeopleBirth Control and Contraception for Young PeopleCondom Tips for Young PeopleDrink, Drugs & SexHaving Safer SexSex, the Internet and TechnologySex, the Law and Young PeopleHIV-positive LifeBeing HIV-positive and HealthyFinding Out That You're HIV-positiveFriends, Attitudes and HIVSex and Relationships for HIV-positive Young PeopleFAQ about sexQuestions About Sex for Young PeopleOther WebsitesGo Ask Alice!Sex, Etc.BBC - The SurgeryPhotos, Videos, Games & Stories Games Play our games to test your knowledge and skills, while learning new facts. See how much you know about HIV/AIDS and sexual health, with our AIDS Game, Sex Education Game, Pregnancy Game and Condom Game. Use your mouse to collect the right letters while avoiding the baddies for a chance to appear on our HI-scores table. Give our games a try now, and see how well you can do! AIDS Game Pregnancy Game Sex Education Game Condom Game Photos & Videos Our media gallery contains hundreds of HIV and AIDS related photos, videos and graphics. You can have a look around, use the search feature, or take a look at some photo selections. Photo Selections Photos & Videos Gallery Media Types Photos Graphics Videos Search the Media Gallery Latest media: Quizzes Try our quizzes to test your knowledge on all aspects of sexual health and HIV and AIDS. We have a Sex Quiz, Pregnancy Quiz, Condom Quiz and an HIV and AIDS Quiz. Just a beginner? Then try the quizzes' easy levels. Think you're an expert? Well try the hard quizzes. AIDS Challenge HIV and AIDS Quiz Pregnancy Quiz Sex Education Quiz Condom Quiz StoriesLesbian and gay storiesComing out StoriesYoung Bisexual and Gay Men: Personal StoriesYoung Lesbian and Bisexual: Personal StoriesHIV and AIDSHIV and AIDS in the FamilyPersonal Stories of Men Living with HIVPersonal Stories of Women Living with HIVPersonal Stories of Young People Living with HIVStories From Around the WorldTalking about sex First Time Sex StoriesStories of Sex EducationSubmit a storyFeatured Story I went through kind of a phase shift from just getting feelings towards this one guy, to be being confused and feeling kind of bi... - Submitted by Wesley Read more >> InternationalYouth Day 2013 Involving youth in the HIV response Giving young people a platform to share their thoughts and experiences raises awareness among their peers and gives an invaluable insight into the needs of this high-risk group. More than 2,400 young people are newly infected with HIV every day, accounting for 40% of new adult infections. Involving youth in the HIV response is key to lowering new HIV infections among the next generation and the role of technology in doing this is now clearer than ever. A sneak preview of results from an AVERT survey, due to be released on International Youth Day 2013 - 12 August, show that most young people prefer to get their sexual health and HIV/AIDS information online or via mobile, as it's quicker, confidential and cheap. But not all youth are the same, we've found regional variations in the type of technology young people prefer - with 67% of respondents from Africa using mobile phones for health information, compared to just 31% in Europe. To commemorate International Youth Day 2013 - 12 August, share your experiences with others by sending AVERT your story. Raise HIV awareness among youth, check out the hints, tips and quizzes below and share them with your friends. Young People Zone Quizzes 'Can't Explain' home pageTemas sobre el VIH y el SIDA ¿Puede Contraer SIDA De. . . ?Síntomas Del VIH Y Del SIDASIDAVIHPruebas De Detección Del VIHVIH, Embarazo, Madres Y BebésVisión General De La Prevención De VIHIntroducción Al Tratamiento De VIH Y SIDALa Evidencia De Que El VIH Causa El SIDALas Estadísticas Del SIDA Y VIH En El MundoSexo, sexualidad y las relaciones ¿Cómo Se Tiene Sexo?Preguntas Generales Sobre SexoUso De Condones, Tipos Y Tamaños De Condones¿Soy Gay? ¿Se Nace Gay? ¿Se Puede Dejar De Ser Gay?Enfermedades De Transmisión Sexual Y Síntomas De ETSMedia, juegos y concursos Fotos y VideosJuegos (en Inglés) Search Avert.org Click to search site search back to content
If a pregnant woman is infected with HIV, she can transmit the virus to her baby during pregnancy, labour and delivery, or breastfeeding. Without treatment, around 15-30 percent of babies born to HIV-infected women will become infected with HIV during pregnancy and delivery. A further 5-20 percent will become infected through breastfeeding.1
Modern drugs are highly effective at preventing mother-to-child transmission of HIV. When combined with other interventions, including formula feeding, a complete course of treatment can cut the risk of transmission to below 2 percent. Even where resources are limited, a single dose of medicine given to mother and baby can cut the risk in half.
A woman who knows that she or her partner is HIV positive before she becomes pregnant can find out about interventions that may be able to protect herself, her partner or her baby from becoming infected with HIV. Doctors will be able to advise which interventions are best suited to her situation, and whether she should adjust any treatment she is already receiving if she is HIV positive.
There are a number of interventions that can reduce the risk of HIV transmission between a couple when attempting to conceive a child. If a couple decide they want to conceive a child through unprotected sex, they should first seek advice on how to limit the risk to each other and to their baby. It is worth noting that someone is less likely to transmit HIV if they are receiving effective antiretroviral treatment, and also if neither they nor their partner has any other sexually transmitted infections.
An HIV positive woman and an HIV negative man can conceive without HIV transmission occurring by using artificial insemination (the process by which sperm is placed into a female's genital tract using artificial means rather than by natural sexual intercourse). This simple technique provides total protection for the man, but does nothing to reduce the risk of HIV transmission to the baby.
Sperm washing is a process used to prevent HIV transmission from an HIV positive man to his partner during conception. Sperm washing involves separating sperm cells from seminal fluid, testing these cells for HIV, then inserting the cells into the woman's womb (intrauterine insemination), or directly into the egg (in vitro fertilisation or intracytoplasmic sperm injection). Sperm washing is a very effective way to reduce the risk of HIV transmission during conception, but it is not widely available and can be difficult to access, even in well resourced countries. Alternatives to sperm washing have been researched, such as the method of using pre-exposure prophylaxis and timed intercourse when the HIV-positive male partner is taking antiretroviral drugs.2
When both partners are HIV positive, it might still be sensible for them not to engage in frequent unprotected sex, because there might be a small risk of one re-infecting the other with a different strain of HIV.
The rest of this page is written from the point of view of a woman who knows she is HIV positive and pregnant.
The drugs that can reduce the risk of HIV transmission from a mother to her baby are called antiretroviral (ARV) drugs. ARVs are the drugs that are taken by people living with HIV to prevent them from becoming ill.
The most important time for an HIV positive pregnant woman to take ARVs to prevent her baby becoming infected is during labour. Depending on your particular circumstances it may be suggested that you take ARVs at other times as well.
Deciding exactly which ARVs to take and when to take them can be quite difficult, because there is a need to balance a number of different things, including:
There may also be a difference between which drugs you would ideally take and which ones it is actually possible for you to take, as there is considerable variation worldwide in the cost of ARVs and their availability.
There are two tests, the CD4 test and the viral load test, that can help you and your doctor decide whether you need treatment for your own HIV infection. The CD4 test tells you how much HIV has weakened your immune system. The viral load test tells you how much HIV is in your blood. A pregnant HIV positive woman with a low viral load is less likely to have an HIV positive baby than a woman with a high viral load. Viral load tests may not be available to all women because of the cost.
If you have a high CD4 count (exactly how high depends on your circumstances and which country you are in), this means that you still have a strong immune system. Your health care provider will probably suggest that you do not start taking drugs for your own HIV infection but will probably advise that you start taking drugs to prevent HIV transmission to your baby.
The choice of drugs you take will depend on a number of factors, including the country you are living in, which drugs are available in the area, and your own personal circumstances. While new WHO guidelines for PMTCT were released in 2010, it is yet to be seen whether these recommendations will be widely adopted. Until then, most women might be able to access recommended drug regimens from the 2006 guidelines which are described below.
If available, you should take longer drug regimens starting earlier in pregnancy (for example, starting 28 weeks into pregnancy), rather than shorter regimens (for example, starting at 36 weeks of pregnancy). However, it will often be recommended that you delay starting treatment until after your first trimester (the first three months of pregnancy). If the drug Zidovudine (also known as AZT or ZDV) is available it will often be suggested that you take it, starting from 28 weeks of pregnancy (or as soon as possible thereafter). AZT is usually taken two or three times daily.
During labour, if available, it will be recommended that you take a combination of ARVs. Combinations are more effective at lowering a woman’s viral load than single-drug regimens and so will be more effective in preventing transmission from mother-to-child. The World Health Organization (WHO) recommend taking AZT and lamivudine (3TC) as well as a single-dose of nevirapine during childbirth/delivery.
Finally you will probably be given ARVs to take for a few weeks after the birth. WHO recommend taking AZT and 3TC for seven days after the birth. Taking this dual combination reduces the chance of developing resistance to the single-dose of nevirapine.
WHO recommend giving the infant a single-dose of nevirapine immediately after the birth and AZT for one week. The nevirapine can be taken up to 72 hours after childbirth, but ideally as soon as possible.
The decision whether or not to stop taking the ARVs after the prescribed regimen has finished depends upon your personal circumstances. Any decision should be made with your health care provider and should be based upon certain situations, such as CD4 count and clinical symptoms. If stopping the drugs, it is important that you stop them in a way that limits the amount of time there is just one drug in your body, as this will reduce the chances of developing drug resistance.
If you need ARVs for your own HIV infection, treatment should be started as soon as possible, even if you are still in the first trimester. Most ARVs do not have any major affects on the fetus during this time, although some drugs are more of a concern than others.3 It is therefore very important to discuss your treatment options with your health care provider.
There are many different ARV drug combinations and those that are recommended are likely to be similar to those recommended if you were not pregnant. AZT will probably be part of the recommended regimen, due to its proven effect to reduce the risk of HIV transmission from mother to child. WHO guidelines recommend an initial regimen of AZT + 3TC + nevirapine (NVP).
If there are very few drugs available where you live then you can take a single dose of NVP during labour to reduce the chances of your baby becoming infected, but you must not take it on its own at any other time. If you do you will increase the chances of drug resistance, and it will not work if you want to take it during labour to protect your baby. AVERT.org has more about single dose nevirapine in our mother to child transmission page.
If you have found out you are pregnant and are already taking ARVs you should seek advice from your health care provider as soon as possible. It is not recommended that you stop taking your ARVs or change your therapy before seeing your doctor. If you stop treatment suddenly during pregnancy then your viral load may increase, which can increase the risk of your baby becoming infected with HIV. Stopping treatment also needs to be done carefully in order to prevent the development of resistance.
If your pregnancy is identified during the first trimester, the benefits and potential risks of taking treatment for both you and the infant will need to be considered. In particular, efavirenz is not recommended during the first trimester and can be substituted for NVP.
If your pregnancy is identified after the first trimester then it will usually be recommended that you continue with your ARV treatment.
There are several ARVs you can take during labour. The question of which ones to take and how long to take them for will depend upon drug availability.
WHO recommended in 2006 a combination of single-dose nevirapine + AZT + 3TC for the woman during labour and delivery, followed by a seven-day tail of AZT and 3TC. Immediately after delivery, it is recommended that the baby is given a single-dose of nevirapine, followed by a course of AZT for four weeks.
If drug availability is very limited, a single-dose of nevirapine for the mother during labour and a single-dose of nevirapine for the baby will probably be recommended as a minimum.
Pregnant women are often advised not to take any medications during their pregnancy, so it can seem strange that HIV positive women are advised to take ARVs when pregnant. However, thousands of women have taken HIV drugs during pregnancy without it causing harm to their babies, and it has resulted in many babies being born HIV negative who might otherwise have been infected.
It cannot be guaranteed that HIV drugs taken when a woman is pregnant will not harm her baby. If a woman is not already taking ARVs then as explained above she will probably be advised to wait until after the first trimester before starting treatment. There are specific recommendations and guidelines (see the sources at the end of the page), about certain antiretroviral drugs and which ones are more of a concern than others. The Antiretroviral Pregnancy Registry monitors the birth defects induced by ARVs.
A caesarean section is an operation used to deliver a baby through its mother’s abdominal wall. When a mother is HIV positive it is done to protect the baby from direct contact with her blood and other bodily fluids.
Research suggests that with many women now taking ARV combination therapy during pregnancy, having a caesarean isn’t a significant factor in preventing the transmission of HIV from mother to baby. Unless you are ill with HIV or have a detectable viral load it usually won’t be recommended by your health care provider, as having a caesarean does itself have some risks for the woman. One exception to this is if you are taking AZT on its own, when a PLCS may still be recommended.
HIV is found in breast milk, and if you breastfeed there is a significant chance of passing HIV to your baby. So if you have access to safe breast milk substitutes (formula) then you are advised to not breastfeed.4
If you live in a country where safe water isn’t available, the risk of life-threatening conditions from formula feeding may be higher than the risk from breastfeeding. Formula can also be too expensive to use regularly in some countries. If you are in this situation it is better to feed your baby breast milk alone.
Mixed feeding is when a baby is fed with breast milk and other liquids such as formula, glucose water, gripe water or traditional medicine. It is now thought that there is a higher risk of a baby becoming HIV positive from mixed feeding than exclusive formula feeding alone or breastfeeding. Mixed feeding may damage the lining of the baby’s stomach and intestines making it easier for HIV in breast milk to infect the baby but when taking ARVs to prevent mother to child transmission, the risk is reduced and is currently recommended by the WHO.
www.avert.org is an information resource to be used for educational purposes only. The information is not intended to serve as a substitute for professional medical advice and we recommend that all decisions about your treatment or products you wish to use should be discussed thoroughly and frankly with your doctor.
english español
Play our games to test your knowledge and skills, while learning new facts. See how much you know about HIV/AIDS and sexual health, with our AIDS Game, Sex Education Game, Pregnancy Game and Condom Game. Use your mouse to collect the right letters while avoiding the baddies for a chance to appear on our HI-scores table.
Give our games a try now, and see how well you can do!
Our media gallery contains hundreds of HIV and AIDS related photos, videos and graphics. You can have a look around, use the search feature, or take a look at some photo selections.
Try our quizzes to test your knowledge on all aspects of sexual health and HIV and AIDS. We have a Sex Quiz, Pregnancy Quiz, Condom Quiz and an HIV and AIDS Quiz.
Just a beginner? Then try the quizzes' easy levels. Think you're an expert? Well try the hard quizzes.
I went through kind of a phase shift from just getting feelings towards this one guy, to be being confused and feeling kind of bi... - Submitted by Wesley Read more >>
Giving young people a platform to share their thoughts and experiences raises awareness among their peers and gives an invaluable insight into the needs of this high-risk group. More than 2,400 young people are newly infected with HIV every day, accounting for 40% of new adult infections.
Involving youth in the HIV response is key to lowering new HIV infections among the next generation and the role of technology in doing this is now clearer than ever.
A sneak preview of results from an AVERT survey, due to be released on International Youth Day 2013 - 12 August, show that most young people prefer to get their sexual health and HIV/AIDS information online or via mobile, as it's quicker, confidential and cheap. But not all youth are the same, we've found regional variations in the type of technology young people prefer - with 67% of respondents from Africa using mobile phones for health information, compared to just 31% in Europe.
To commemorate International Youth Day 2013 - 12 August, share your experiences with others by sending AVERT your story. Raise HIV awareness among youth, check out the hints, tips and quizzes below and share them with your friends.