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WHEN FIRST DIAGNOSED: UNDERSTANDING AND COMMUNICATING ABOUT
HIV-WHAT YOU NEED TO KNOW: WHAT’S AT STAKE IN BECOMING PREGNANT
Women who have HIV and then become pregnant can transmit this virus to their babies. Women who become infected with HIV while they are pregnant can also transmit the virus to their babies. The risk of transmission is around 30 percent to 35 percent, meaning that about one-third of the babies born to mothers with HIV will also have the virus.
A woman who becomes infected with HIV after she has had a baby has less to worry about. Any woman with HIV infection, regardless of when she became infected, must not breast-feed her baby.
HIV infection is .different in children than in adults. Because researchers have been reluctant to do clinical trials (drug studies) with children, physicians know less about treating children. And in children, the disease progresses more rapidly. Most children with HIV infection will have medical problems by age four or five years, although rare children with HIV remain well until they reach eight, nine, or ten years of age.
Because the chances of transmitting HIV to a fetus are high, and because children with HIV have little hope of cure, women with HIV are usually advised to avoid pregnancy. They are counseled to use effective methods of birth control: not only condoms, but also additional kinds of contraception, like the pill. The same applies to women who are having sex with infected men. Nonsafe sex with an infected man can make you pregnant and can expose you to the virus at the same time. The pill will help prevent pregnancy, but will not prevent the transmission of HIV. Condoms are not as fail-safe as the pill for preventing pregnancy, but are a pretty good barrier to the transmission of HIV.
For women who are already pregnant, the consequences of delivering the baby and the option of abortion should be thought out carefully. Women with HIV infection often say that since the chances that the baby will not be infected with HIV are 65 percent or better, they should not consider abortion. But even a healthy baby can be devastated by HIV infection if the mother or father or brother or sister is infected. You must think carefully about who will care for your baby if your own health should worsen. These things are best considered during the first three months of pregnancy; if you want an abortion, this is the time when abortion is safest.
If a woman has already given birth without prior testing and subsequently learns she has HIV, she should have all her children of preschool age tested. Older children who have remained healthy and developed normally are unlikely to have HIV infection, but some mothers will still want the reassurance of a negative blood test.
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