Does Being HIV Positive Affect Pregnancy and Childbirth?

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The human immunodeficiency virus (HIV) has existed in the United States for decades, with the first media report of this mysterious new illness being published on May 18, 1981. There are approximately 258,000 women in the US who live with HIV. While the virus is incurable, it can be managed with ongoing antiretroviral drug treatment. Medication effectively prevents the condition from progressing, meaning that the infected person has an undetectable viral load, and is able to retain their cell-mediated immunity. Advances in treatment mean that cases, where HIV progresses to acquired immunodeficiency syndrome (AIDS), are rarer and rarer in the developed world. Despite an ability to manage the condition, does being HIV positive mean a woman shouldn't become pregnant? 

HIV and Parenthood

Being HIV positive is certainly a significant factor in a woman's reproductive health. However, HIV is not incompatible with parenthood. In fact, back in 2019, New Zealand opened the world's first HIV-positive sperm bank. Intended to help overcome the stigma attached to being HIV positive, the sperm donations are from men with undetectable viral loads. In any event, it demonstrates that being HIV positive isn't a hindrance to pregnancy, nor must it have an adverse effect on a baby's health. In short, an HIV-negative baby can be born to an HIV-positive mother.

Precautions

HIV-positive women who are planning to fall pregnant should remember that while the risk of passing HIV onto their baby is low, it still exists. This risk can be efficiently mitigated with a few precautions. Your physician or obstetrician will discuss these measures with you, but they may include:

  • Amendments to your antiretroviral drug treatment during pregnancy may be recommended. This essentially boosts the effectiveness of the medication, allowing your baby to be protected from contracting the virus while in utero. 
  • You may be advised to have your baby via cesarean delivery. This is because the rupturing of your amniotic sac (when your water breaks) can expose your baby to elevated levels of the virus during vaginal delivery. 
  • As a precautionary measure, your baby may be given medication shortly after birth. This will be a form of post-exposure prophylaxis (PEP), similar to the medication given to an adult after exposure to HIV. This prevents the virus from infecting the host.
  • You will be advised not to breastfeed your baby. The risk of transmission may not be high, but it remains possible. In the best interests of your baby, it's necessary to eliminate this potential method of transmission.

Being HIV positive doesn't mean you can't have a baby. It does mean that some extra vigilance becomes essential. Contact a company like New Voices for Reproductive Justice for more information. 

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