Information for pregnant women who have HIV

If you have HIV (the virus that causes AIDS) and are pregnant, you probably have many questions. This handout will help you learn about:

• whether your baby will have HIV too;

• the best way for you to deliver your baby; and

• what will happen to your baby after birth.

I AM HIV POSITIVE AND PREGNANT. WILL MY BABY BE INFECTED TOO?

Without treatment, your baby has a one in four chance of getting HIV. But there are things that can help reduce the risk. During your pregnancy and delivery, you can take a drug called zidovudine. If your newborn baby also receives this drug, the chance of the baby being infected with HIV drops to about one in 20. As well, if you are taking special drugs for HIV such as a triple combination that lowers your viral load, it is even less likely that your baby will be born with HIV.

IF I AM HIV POSITIVE AND PREGNANT, SHOULD I DELIVER THE BABY BY CAESAREAN SECTION?

If you are not taking any medicine for HIV or if you are just taking zidovudine, it is better for your baby to be delivered by caesarean section rather than vaginally. Otherwise, the risk of your baby being infected with HIV is twice as great if you deliver vaginally.

If you are taking a combination of drugs (to control your infection) and the amount of virus circulating in your blood is undetectable, there seems to be no clear advantage for a caesarean delivery compared with a vaginal delivery. You should talk to your doctor, who can look at your particular situation and give you appropriate advice for your situation.

IF I TAKE ANTIRETROVIRAL DRUGS DURING PREGNANCY, WILL THAT HURT MY BABY?

Not very many pregnant women have taken these drugs and the babies born to these women are still very young. To date, children exposed to these drugs during pregnancy haven’t had major problems. It’s still too early to say for sure that there will not be problems. If you have questions about taking HIV drugs during pregnancy, you should call this toll-free number: 1-888-246-5840.

DO BABIES WITH HIV INFECTION LOOK DIFFERENT?

No.

WHEN WILL I KNOW WHETHER MY BABY IS HIV POSITIVE?

Blood tests will tell whether the virus has been passed on. There are usually three tests performed:

• within the first few days of the baby being born;

• at 1 month of age; and

• at 2 to 4 months of age.

If all 3 tests are negative for HIV, the baby does not have the virus. If any one of the tests is positive, another test is performed. If 2 tests are positive, then the baby is infected with HIV.

IF I AM HIV POSITIVE, SHOULD I BREASTFEED MY BABY?

No, the baby could get HIV from your breast milk.

IF I AM HIV POSITIVE, WILL MY BABY NEED ANY EXTRA MEDICINE?

Your baby should be given a drug called zidovudine (in syrup form) for 6 weeks to provide extra protection against HIV infection. After that, until you know whether the baby is HIV positive, the baby should be given an antibiotic (called trimethoprim/sulphamethoxazole [TMP/SMX], also known as Septra [manufactured by Glaxo Wellcome Inc] or Bactrim [manufactured by Hoffmann-La Roche Limited]), to help to prevent pneumonia that can occur in babies with HIV infection.

SHOULD MY BABY GET THE SAME VACCINES (NEEDLES OR SHOTS) AS OTHER BABIES?

Yes, your baby should follow the same vaccine schedule as other babies.

SHOULD I TAKE MY BABY TO AN EXPERT?

Your doctor should check with a specialist in HIV in children to make sure that you and your baby get the information and services that you need. Most HIV specialists are part of a team of health care workers (doctors, nurses, social workers, dieticians, pharmacists, physiotherapists and occupational therapists), and some of those people may be useful resources for you, too.