HIV and Pregnancy
From its first recognized appearance in the 1980s until today, HIV and HIV/AIDS has infected millions of people. According to the March of Dimes, there are now between 120,000 and 160,000 American women who have been infected with the HIV virus. Of that number, between 6,000 and 7,000 give birth every year. Since the epidemic began more than 30 years ago, approximately 15,000 children in the US have been infected and 3,000 have died from the disease. Nearly 90 percent of those children who have HIV were infected with the virus through their mother either during pregnancy or birth.
Perinatal transmission is the most common method of HIV transmission from mother to baby and occurs during pregnancy, labor, delivery or breastfeeding.
What is HIV/AIDS?
HIV stands for human immunodeficiency virus. It is a virus that only infects human beings. It weakens the immune system by destroying important cells that fight disease and infection. An immune system that is deficient cannot adequately protect against disease. Since it is a virus, it can only reproduce by taking over cells in the host body. Although other viruses can be gotten rid of, either over time or with the use of drugs, the human immune system cannot rid itself of HIV. It can hide for long periods of time in the cells of the body and silently attack key cells associated with the immune system. A person may be HIV positive yet not have AIDS. AIDS may not develop for 10 years or more, however, the person with the virus can still transmit it to others when infected blood, semen or vaginal fluids come into contact with broken skin or mucus membranes.
AIDS is acquired immunodeficiency syndrome and is caused by HIV. As cells are progressively damaged by HIV, the body becomes more vulnerable to infections that it can't fight off effectively. When the HIV infection becomes advanced, opportunistic diseases are able to take hold of the individual and the diseases are treatment-resistant. At this point, a person has AIDS. A person can have HIV and not have AIDS.
Pregnant with HIV
If a woman has HIV and is pregnant, the risk of passing the virus to her baby is minimized if she takes good care of her health. With the new treatments available today, an HIV positive mother who is in treatment can reduce the risk of infecting her baby to a two percent chance or even less. Untreated women pass the virus to their babies in 25 percent of births.
There are factors that will enhance the risk of passing of the virus to an unborn baby:
· Substance abuse
· Vitamin A deficiency
· Large quantity of HIV in the blood (clinical stage HIV)
· Labor and delivery factors
It is recommended by the March of Dimes that all women who are planning to become pregnant and have been exposed to HIV be tested, as should their partners, before becoming pregnant. Counseling and voluntary testing during pregnancy should be offered to women who became pregnant before they were tested. If a woman has not been tested during her pregnancy, she can be screened during labor and delivery with tests that can produce results within an hour, allowing for treatment for the baby if the results are positive.
There are several places a woman can receive testing and get information about testing. Recently, the FDA approved the Home Access HIV Test System which allows for confidential testing in the privacy of the home.
Most of the time HIV does not cross the placenta, especially if the mother is otherwise healthy. In-uterine infections, a recent HIV infection, advanced HIV infection or malnutrition reduce the protective ability of the placenta. A healthy diet, prevention of iron or vitamin deficiencies and weight loss and special interventions in the case of STDs or other types of infections are all part of the prenatal care for HIV positive pregnant women. It is important for caregivers to avoid performing any types of invasive procedures like amniocentesis, to avoid transmitting the virus to the baby.
HIV Treatments For Pregnant Women
There are treatments available for HIV positive women who are pregnant that help the mother and protect the baby. If no preventative steps are taken, the risk of transmission during childbirth is between 10-20 percent. The risk increases if the baby is exposed to HIV-infected blood or fluids. Rupturing the amniotic sac should be avoided in infected women, as should episiotomies because they expose the baby to infection with HIV. Cesarean sections performed before rupture of the membranes and/or labor is the best way to avoid unnecessary contact with infected fluids or blood.
Treating a woman with HIV drugs during her pregnancy and treating her baby within eight to 12 hours of birth has decreased the risk of passing the virus by 66 percent. The infection rate drops significantly when the mother is adequately treated and stays healthy.