Deciding to become pregnant when you are HIV positive is a significant and carefully considered choice. Fortunately, with a well-planned approach, you can take proactive steps to ensure the health and safety of both you and your baby. If you are already aware of your HIV status or if the pregnancy wasn't planned, rest assured that there are effective strategies available to protect your baby from contracting HIV.

Screening for HIV

During your first prenatal visit, an essential part of the process includes screening for the HIV antibody, typically done through a test called the "ELISA." This is a proactive step to empower you with the knowledge to make informed health decisions.

However, keep in mind that a negative ELISA test does not entirely exclude the possibility of HIV infection. If you have recently been infected, it might take several weeks before antibodies are detectable. This is known as the "window" period.

If your ELISA screening returns a positive result, it does not necessarily mean you have an HIV infection. Other conditions could lead to a false positive. These include:

• Lyme disease
• Syphilis
• Lupus

If you do receive a positive ELISA result, a more definitive test called a Western blot will follow. A positive result on this test confirms an HIV infection. Nevertheless, if the Western blot comes back negative, it negates the initial ELISA, indicating a false positive. In cases where results are unclear, further testing is essential.

How likely is transmission?

Without preventative medication, there is a 20% to 45% likelihood that an HIV-positive mother could transmit the virus to the baby during delivery or breastfeeding. However, by opting for preventive antiretroviral therapy, you can substantially reduce this risk to around 2%, showcasing the tremendous power of treatment. Even in areas with limited healthcare resources, one or two doses can still significantly mitigate the risk.

Planning for pregnancy

For those who are HIV positive and considering pregnancy, thoughtful planning is essential. Consulting with a doctor will provide you with personalized guidance, addressing the complexities of HIV in the context of pregnancy. You’ll understand how the stage of the disease influences your treatment options and how current therapies can be safely adjusted.

If your partner's safety during conception is a concern, consider methods like artificial insemination. This technique ensures the health of your partner without impacting the baby’s well-being. For HIV-positive men, sperm washing, combined with in vitro fertilization, offers a route to reduce transmission risk. Although it's not universally available, where feasible, it represents a useful option.

Even if both partners are HIV positive, it's wise to refrain from unprotected intercourse due to the potential of re-infection with different HIV strains. If unprotected sex happens, ensure it coincides with ovulation and that both partners are on antiretroviral medications.

Are HIV drugs safe during pregnancy?

Understandably, you might feel cautious about taking medications during pregnancy, but antiretroviral (ARV) drugs have been shown to be beneficial for pregnant women with HIV. There is a strong record of healthy births to mothers taking these medications, making them a vital tool for minimizing transmission risk. Nonetheless, as with all treatments, individual outcomes can vary. Your healthcare provider might suggest starting ARVs after the first trimester if you weren't on them pre-conception.

Do not hesitate to reach out to a healthcare professional with any questions or concerns. They are there to provide the support and advice needed to keep both you and your baby healthy throughout your pregnancy journey.