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Diagnosed while pregnant

pregnant euopean woman

If you discover that you are HIV positive while you are pregnant, taking anti-HIV drugs can dramatically reduce the risk of you passing on HIV to your baby.

Discovering that you are HIV positive while you are pregnant can be a shock. As well as the emotions and questions you will have about your diagnosis, you will also have questions about what it means for your baby.

Our Parenthood section has extensive information about all stages of pregnancy for HIV-positive mothers-to-be.


Will my baby be born with HIV?

As long as several conditions are met, the chances are extremely low. Transmission of HIV from mother to baby can be prevented by:

  • taking HIV treatment,
  • making a careful choice between a Caesarean and vaginal delivery,
  • not breastfeeding, and
  • giving the baby HIV treatment for a few weeks.

In the UK, because of high standards of care, the risk of HIV being passed from mother to baby is very low.

For women who are taking effective HIV treatment and who have an undetectable viral load when their baby is born, the risk of transmission to their baby is 0.1%, or one in 1,000.


Will I have to start HIV treatment?

Yes. In the UK it’s now recommended that everyone diagnosed with HIV starts treatment straight away – regardless of their CD4 count.

If you were diagnosed with HIV before you fell pregnant you are probably already taking treatment. Your doctor will advise you whether it needs to be changed at all.

If you are newly diagnosed during your pregnancy you will need to start taking treatment and will continue to take it after your pregnancy in line with the new BHIVA guidelines.


How will HIV treatment stop my baby getting HIV?

HIV treatment has two effects when you’re pregnant:

  • it protects your immune system, helping to keep you well
  • it reduces the level of HIV in your body (your viral load), which helps to prevent HIV being passed on to your baby.

Research and experience suggest that anti-HIV drugs are safe to use in pregnancy - treatment during pregnancy is a very important part of preventing HIV being passed on to your baby.

If you’d like to have a vaginal delivery, you’ll need to:

  1. be on combination therapy
  2. have an undetectable viral load

You and your doctor should discuss your circumstances and preferences, and you should have time to ask questions.


Do I have to have a caesarean?

Women in the UK are encouraged to prepare a birth plan, which is a record of your preferences for the birth, including the type of delivery you would prefer.

Your doctor will look at your viral load when you are 36 weeks pregnant and discuss options with you.

If you have an undetectable viral load, you can plan to have a vaginal delivery. 

If your viral load is detectable, but very low (under 400), your doctor will look at your particular situation and discuss options with you.

If your viral load is above 400, it is recommended you have a planned Caesarean section.

Find out more about staying healthy during your pregnancy and increasing your chances of having a healthy, HIV negative child.


Is help available?

If you are diagnosed with HIV while pregnant, then you may need emotional support in coping with your diagnosis, as well as information about transmission and treatments. Positively UK is a charity providing support to people living with HIV and can offer you friendly advice and support.

Body and Soul also provide support for families and children who are living with or affected by HIV.

Visit our resource for HIV positive mothers-to-be for more information on all stages of your pregnancy and beyond.

You can also get help from our online peer support volunteers who run daily group sessions within our community forums.

 

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The Information Standard: Certified member

This article was last reviewed on 21/4/2016 by Anna Peters

Date due for the next review: 21/4/2019

Content Author: Kerri Virani

Current Owner: Health Promotion

More information:

BHIVA guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015, Writing Group: Duncan Churchill Chair Laura Waters Vice Chair N Ahmed, B Angus, M Boffito, M Bower, D Dunn, S Edwards, C Emerson, S Fidler, †M Fisher, R Horne, S Khoo, C Leen, N Mackie, N Marshall, F Monteiro, M Nelson, C Orkin, A Palfreeman, S Pett, A Phillips, F Post, A Pozniak, I Reeves, C Sabin, R Trevelion, J Walsh, E Wilkins, I Williams, A Winston

No one with an undetectable viral load, gay or heterosexual, transmits HIV in first two years of PARTNER study, NAM, Aidsmap, Gus Cairns, March 2014

START trial finds that early treatment improves outcomes for people with HIV, by Gus Cairns, NAM, Aidsmap, May 2015

New British guidelines recommend treatment for everyone living with HIV, by Keith Alcorn, NAM, Aidsmap, June 2015

START trial provides definitive evidence of the benefits of early HIV treatment, by Liz Highleyman, produced in collaboration with hivandhepatitis.com, NAM, Aidsmap, July 2015

British HIV Association guidelines for the management of HIV infection in pregnant women 2012 (2014 interim review), by: Dr Annemiek de Ruiter, Dr Graham P Taylor, Ms Polly Clayden, Dr Jyoti Dhar, Mrs Kate Gandhi, Dr Yvonne Gilleece, Dr Kate Harding, Dr Phillip Hay, Ms Jane Kennedy, Dr Naomi Low-Beer, Dr Hermione Lyall, Dr Adrian Palfreeman, Dr Siobhan O’Shea, Dr Pat Tookey, Ms Jennifer Tosswill, Dr Steven Welch, Dr Ed Wilkins, 2012/2014

de Ruiter A et al. Guidelines for the management of HIV infection in pregnant women 2012 BHIVA 2012

Lehman DA & Farquhar C Biological mechanisms of vertical immunodeficiency virus (HIV-1) transmission. Rev Med Virol 17: 381-403, 2007

Townsend C et al. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 22: 973-981, 2008