HIV living with treatment in pregnancy

Overview

HIV (human immunodeficiency virus) is a virus that attacks the immune system. With treatment, people living with HIV can have long, healthy lives and can have children without passing the virus to them. During pregnancy, the goal is to keep the mother healthy and prevent the baby from getting HIV.

HIV is a global health condition that affects millions of people. With modern medicines, many women living with HIV have healthy pregnancies and deliver HIV-negative babies.

This affects women who are living with HIV and are pregnant or planning to become pregnant.

Symptoms

Common symptoms

• Many people with HIV on treatment have no symptoms. Some may have mild flu-like illness when first infected, but this often goes away.

Symptoms in children

• Babies born to mothers with HIV who receive preventive treatment are usually healthy and do not show symptoms of HIV.

Symptoms in older adults

• Older adults with HIV on treatment generally have a similar symptom profile as younger adults, but may have higher risk of other age-related conditions.

Causes

Main causes

• HIV is caused by the human immunodeficiency virus. It is spread through blood, semen, vaginal fluids, and breast milk.

Risk factors

• Having unprotected sex with an infected partner
• Sharing needles or syringes
• Being born to a mother with HIV who did not receive treatment during pregnancy

When to see a doctor

See a doctor urgently if:

• If you have any signs of infection, such as fever, chills, or a cough that gets worse.
• If you miss a dose of your HIV medicine and are unsure what to do.

Book a routine appointment if:

• As soon as you know you are pregnant, make an appointment with your HIV doctor and your midwife or obstetrician.
• Throughout pregnancy, you will have regular check-ups and blood tests to monitor your viral load and overall health.

Diagnosis

HIV is diagnosed with a blood test that checks for the virus itself or for antibodies (proteins your body makes to fight the virus).

Tests that may be done

• HIV antibody/antigen test
• Viral load test (measures amount of virus in the blood)
• CD4 count (measures the strength of your immune system)

What to expect at your appointment

If you have HIV and are pregnant, your healthcare team will monitor you with regular blood tests. The goal is to keep your viral load undetectable throughout pregnancy and delivery.

Treatment

Treatment for HIV is called antiretroviral therapy (ART). It is a combination of medicines that lower the amount of virus in your body. During pregnancy, taking ART every day as prescribed is crucial to keep you healthy and to protect your baby from getting HIV.

Self-care at home

• Take your HIV medicines exactly as prescribed, at the same time each day.
• Attend all antenatal appointments and blood tests.
• Eat a balanced diet and get moderate exercise as recommended by your healthcare team.
• Avoid alcohol, smoking, and recreational drugs.

Medical treatments

Your doctor will prescribe a combination of antiretroviral medicines that are safe to use during pregnancy. Never stop or change your medicines without talking to your doctor. During labour, you may be given intravenous (IV) treatment to keep your viral load low. After birth, your baby will receive preventive medicine for a few weeks.

Living with this condition

Living with HIV while pregnant involves taking daily medication, attending regular check-ups, and planning for a safe delivery. Most women lead normal lives, work, and take care of their families.

Lifestyle tips

• Get enough rest and manage stress through relaxation or gentle activity.
• Stay in close contact with your healthcare team and ask questions when you have them.
• Talk to your partner or a trusted person about your feelings.

Diet and exercise

Eat a healthy diet rich in fruits, vegetables, whole grains, and lean protein. Gentle exercise like walking is usually safe during pregnancy, but always check with your doctor first.

Mental health and emotional wellbeing

A diagnosis of HIV can bring up a range of emotions – worry, sadness, or stress. It is normal to feel this way. Speak to a counsellor, social worker, or join a support group for pregnant women living with HIV.

Prevention

Yes, with proper treatment during pregnancy and delivery, and by avoiding breastfeeding, the risk of passing HIV to your baby can be less than 1%. If you do not know your HIV status, ask your healthcare provider for a test.

Vaccines

There is no vaccine to prevent HIV, but your healthcare provider will recommend vaccines that are safe during pregnancy, such as the flu shot and whooping cough vaccine.

Screening programmes

All pregnant women should be offered an HIV test as part of routine antenatal care. Early diagnosis allows you to start treatment and protect your baby.

Complications

If left untreated

• HIV can be passed to the baby during pregnancy, labour, delivery, or through breastfeeding.
• Untreated HIV can weaken the mother's immune system, making her more likely to get serious infections.
• Without treatment, the mother's viral load stays high, increasing the risk to baby and long-term health for the mother.

Long-term outlook

With modern HIV treatment, the outlook is excellent. Most women with HIV have healthy pregnancies and give birth to HIV-negative babies. Staying on treatment keeps you healthy and allows you to live a long, full life.

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