Medications & Labor and Delivery
Q: What is the chance that I will transmit the virus to my baby?
A: There have been many advances in the prevention of HIV transmission from mother to child. Without any treatment, the risk of transmission is one in four, about 25% chance. Luckily, there are steps that can be taken to reduce the risk to less than 2%.
Q: What can I do to reduce my risk of transmission?
A: Preventing HIV transmission to the baby takes a lot of steps. It is most important that you see your doctor regularly so that they can monitor your health and the pregnancy. Some of the main steps to prevent transmission are:
- Prenatal care (attending all visits)
- Specialty HIV care (all visits)
- Anti-HIV drugs (during pregnancy, at a delivery and for the baby)
- Formula feeding (Breastfeeding is strongly discouraged as this increases the chance of transmission)
Q: How can I find a good doctor?
A: HIV can sometimes be complicated to treat. There are doctors who specialize in treating people with HIV. You can get a referral to an HIV specialist in your area by calling 1-800-439-4079.
Q: What can I do to become pregnant safely if I am HIV-positive?
A: Consult your doctor about the safest method for you to conceive. This will likely include taking anti-retroviral medicines and getting an undetectable viral load. There are various methods to help couples conceive that will take into account the HIV status of both partners to reduce the risk. While there is some risk of HIV infection, or HIV re-infection, there are ways to reduce or eliminate that risk to both parties.
Q: What if I am negative and my partner is HIV-positive?
A: If a woman is HIV-negative and her partner is HIV-positive, there is no risk of perinatal transmission to the baby. However, pregnant women are STILL AT RISK for HIV infection and condoms must be used every time to prevent transmission of HIV to the mother while pregnant. A woman who becomes HIV-positive while pregnant has a greater chance of transmitting the virus to her baby. Because of the risk of HIV infection, it is recommended that all women in Illinois be tested again for HIV in their third trimester of pregnancy.
Q: If I am HIV-positive and pregnant, do I have to disclose my HIV status to anyone?
A: Your HIV status is your business. You do not have to tell your family, your friends, your employer, or your landlord that you are HIV positive. The only people you are required to tell are people you have sex with or share needles with. No one who knows or learns your HIV status is allowed to tell anyone else without your explicit written permission.
You will want to tell your medical providers about your HIV so that they can make sure you have the best care possible. There are sensitive providers who specialize in providing care to HIV-positive pregnant women. Call the 24/7 Hotline at 1-800-439-4079 to get a referral to a provider near you.
Medications & Labor and Delivery
Q: Are HIV medications really safe for me while I am pregnant?
A: Your doctor will recommend a regimen of medications that is best for you and your lifestyle. While there are some side effects to the medications, they usually only last for a short time and are well worth the benefit of preventing transmission to your baby! Please tell your doctor about ALL side effects from your medicines and they may be able to help manage those side effects for you.
Q: How do I decide about vaginal or c-section delivery?
A: The best decisions about route of delivery are made together between a woman and her doctor. Certain obstetrical factors about your previous pregnancies and the current pregnancy (non-HIV related) will be weighed in the decision.
Q: What if I don't have insurance? How will I afford my medications?
A: In Illinois, all pregnant women are eligible for Medicaid - regardless of their legal status in this country. If a woman is uninsured prior to pregnancy, she should go to her nearest Public Aid office to apply for a medical card as soon as possible. Medicaid covers all necessary HIV medications. The AIDS Drug Assistance Program, or ADAP, is a federally funded program that also covers HIV medications for those inpiduals without insurance or inpiduals with insurance who meet the financial criteria. This program varies from state to state, but in Illinois there is no waiting list of ADAP applicants. While pregnant in Illinois, women covered by Medicaid should not need ADAP to cover medications, but this may be a helpful resource post-partum, if Medicaid is discontinued.
Q: What can I do if I feel overwhelmed?
A: We recommend that you seek out individuall help or a support group (online or in person). HIV and pregnancy can be really isolating. There are professionals that can help you talk about your feelings, talk to your partner about your diagnosis, safe sex and dealing with learning about your diagnosis during pregnancy. Many women find out about their HIV status through prenatal testing. You are not alone.
Q: What else can I do to become an informed patient?
A: Many women are eligible to see a case manager or social worker. They can help make sure that your basic needs (food, housing, transportation) are met in addition to helping to link you to support groups or other services that you may need.
Q: I have more questions! Where can I find more resources?
A: Project Inform (www.projectinform.org) has a great website with lots of other fact sheets on pregnancy and HIV. AIDSinfo (AIDSinfo.nih.gov) also has excellent resources. Other websites for women include www.TheBody.com and www.thewellproject.org.