Two HIV-positive parents can most certainly have an HIV-negative child thanks to modern medicine. HIV is known to be transmitted through vertical transmission. This means that an HIV-positive mother can pass on the virus to her baby during pregnancy and birth. HIV can also pass through the mother to the baby through breastfeeding. However, despite an established transmission route, the risk of HIV transmission can be minimized significantly if timely action is taken.
COUNSELING FOR HIV POSITIVE COUPLES
HIV-positive couples should receive proper medical counseling even before they decide to get pregnant. Many decisions need to be made regarding the pregnancy, and proper counseling can help make these decisions easier.
Counseling helps HIV-positive couples understand the risk to their baby during pregnancy and birth. Based on this understanding, their doctor might recommend a tailored program to help minimize the risk of infection to their baby. There are multiple treatments available that decrease the viral load in the mother and, thus, reduce the risk of infecting the baby. The same treatment can also help treat the child in case it is born with HIV.
Couples also need to evaluate their health status and how it would affect their lives together as a family once they get pregnant. Difficult questions such as whether or not HIV-positive couples might be able to raise their newborns need to be addressed beforehand effectively. Psychiatric counseling on coping with the stigma of HIV is an important aspect of managing HIV-positive couples.
SHOULD A WOMAN TAKE ART WHILE PREGNANT?
HIV-positive mothers should take Anti-retroviral therapy (ART) during pregnancy at all costs. The medication will reduce the risk of infection in the child and improve his mother's health status, contributing to a healthier parenting situation in the future.
Women who were already taking ART before getting pregnant should continue to take it when they get pregnant. Regular visits to a physician are important since your doctor might need to alter your treatment regime to cater to pregnancy-related complications. Additionally, regular visits to the OB/GYN and infectious disease provider are also important to make sure that a team collaboration approach is sustained to decrease the risk of your baby contracting the virus and that you are healthy during the time your baby is growing.
The goal of ART treatment during pregnancy is to reduce the viral load in the mother. Viral load refers to the detectable level of HIV per unit of blood. Suppose the viral load is "undetectable," the risk of vertical transmission of the virus is reduced significantly. According to studies, there is only a 0.4% chance of the baby acquiring the virus if the mother is taking ART regularly.
SHOULD THE BABY RECEIVE TREATMENT AFTER BIRTH?
Even if the mother has an undetectable viral load, the baby should be treated for HIV immediately after birth for at least 4-6 weeks. This is done to reduce the risk of HIV infection in the newborn. If the mother could not maintain undetectable viral loads during pregnancy, the duration of treatment for the baby might be longer. This is because detectable viral loads increase the transmission of the virus from mother to baby.
Breastfeeding by an HIV-positive mother should be avoided after birth since breast milk carries HIV in it.