HIV Pregnancy – Falling Pregnant when HIV Positive

People living with HIV have the same reproductive rights as any other person and it is not uncommon for an HIV positive man or woman to consider having a child despite the risks associated with conception. However, women who are HIV positive and planning to fall pregnant or women who are negative but wanting to conceive with a partner who is HIV positive have much to consider before conception. The priority is a healthy pregnancy without transmitting the infection to the child and this is achievable with effective HIV management.

Conception and HIV

Many women have fears surrounding pregnancy which is only natural, however, when HIV comes into the equation there are many more points to consider before conceiving.

A woman who is HIV negative but wants to conceive with a partner who is positive has to bear in mind that during unprotected sex (without a condom), which is necessary for conception, there is a fair chance that she may be infected with HIV. The converse is also true for a woman who is HIV positive and wants to have intercourse with a man who is not infected. While circumcision has been shown to reduce the chances of HIV transmission, this is not fool proof and there is still a risk for the male partner.

Will I become ill if I am HIV positive and pregnant?

There is no effect that has been noticed in terms of  pregnancy on HIV disease progression. However, pregnancy can be quite taxing on the body and a pregnant HIV-positive mother should take greater care. Plenty of rest, eating well balanced meals and avoiding contact with those who have infectious illnesses is essential. Avoid unprotected sex while you are pregnant even if you are HIV-positive, as different strains of HIV could complicate the situation.

Will pregnancy cure me of HIV/AIDS?

No. This is one of the many HIV/AIDS myths that have propagated many years ago and there is no truth to it. If any person has told you that you can cure HIV by falling pregnant, you should ignore the advice. It does not mean that if your baby is HIV negative then you are now negative.

Miscarriage in HIV Pregnancy

The chances of a miscarriage is higher in a case where the mother is HIV positive although this does depend on the CD4 count and viral load. However, miscarriages are not confined only to HIV infection. Many other infectious diseases can result in a miscarriage. An HIV-positive woman who is pregnant should take greater care not to contract infections from others and even a simple case of the flu (seasonal influenza) can jeopardise the pregnancy if it is prolonged and leads to complications.

HIV Transmission to the Unborn Baby

There is a risk of transmitting the infection to the unborn baby, however, the use of appropriate antiretroviral medicines will reduce the chance of mother-to-child transmission. Studies have shown that women with a viral load below 1,000 copies/ml have an almost 0% chance of transmission. Almost? The risk always exists and prospective mothers should be aware of this.

When should ARV’s be started in pregnancy?

Antiretrovirals may be started by the 28th week of pregnancy, however, this depends on a number of factors and it is best to immediately inform your doctor about your pregnancy if you are HIV-positive. There are situations where ARV’s may be started sooner so it is essential to know your HIV status as soon as possible.

Even if your CD4 count is high, antiretroviral drugs will still be administered as a prophylaxis – this means that it is intended to prevent HIV transmission to your child. Certain ARV’s are contraindicated in pregnancy and therefore it is important to notify your doctor about your pregnancy so that you can be prescribed other antiretroviral drugs.

Can I breastfeed my baby?

If you are HIV-positive, it is advisable not to breastfeed. While “breast is best”, the chance of vertical transmission of HIV is significantly high and mothers need to be aware of the risk to the baby. In the event that a pregnant woman insists on breastfeeding, the doctor will advise measures that need to be taken to reduce the chance of transmitting the virus to the baby.