Myths and Truths about HIV/AIDS and Births

Myths Truths
An HIV seropositive woman cannot have children. HIV seropositive women at childbearing age can give birth to a child unless other health problems causing infertility coexist. The risk of miscarriage, however, is greater in advanced stages of the disease.
A HIV seropositive pregnant woman will transmit HIV to her child. The risk that a mother will pass HIV onto her child during pregnancy, labour and breastfeeding (vertical transmission) is around 25%, without any intervention. A combined approach that includes administration of antiretroviral treatment to both the mother and her infant – before, during, and after labour – cesarean section and avoidance of breastfeeding reduces the risk to 1–2%.
A HIV seropositive pregnant woman must always have a cesarean section to reduce the risk of transmitting HIV to her baby. In the past, cesarean section was chosen over vaginal birth because the former reduces the newborn’s exposure to its mother’s blood and other bodily fluids. Nowadays, given the advances in antiretroviral drugs which can suppress maternal HIV viral load even to undetectable levels, cesarean section is recommended when the mother’s viral load is higher than 1000 copies/ml or there are other reasons unrelated to HIV infection.
Pregnancy accelerates the clinical progression of HIV disease. According to relevant studies, pregnancy does not seem to affect the clinical progression of HIV disease.
A HIV seropositive pregnant woman should not receive antiretroviral drugs during pregnancy due to the potential toxic effects on both her and the fetus. According to the recent guidelines, pregnancy is not a reason for interrupting antiretroviral treatment. On the contrary, antiretroviral treatment initiation is recommended for all HIV-infected pregnant women. When a HIV seropositive woman becomes pregnant, she should not stop receiving treatment. The attending physician may modify the regimen to prevent potential toxic effects on the mother and the fetus. If the HIV seropositive pregnant woman has never received antiretroviral drugs in the past, treatment initiation is recommended to minimize the risk of vertical HIV transmission. There are many treatment options available allowing the attending physician to prescribe the most appropriate antiretroviral regimen in terms of effectiveness and safety.

Hellenic Society for the Study and Control of AIDS