martes, 9 de julio de 2013

Pregnancy and HIV/AIDS |

Pregnancy and HIV/AIDS |
07/05/2013 03:06 PM EDT

Source: Department of Health and Human Services, Office on Women's Health
Related MedlinePlus Page: HIV/AIDS and Pregnancy
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pregnant woman
Did you know?

You should be in the best health possible before becoming pregnant. Visit our pregnancy section to learn what steps you can take now to give your baby the best chances for a healthy start to life.

Pregnancy and HIV/AIDS

Motherhood is a wonderful experience. Regardless of your HIV status, you may want to have children. HIV can be spread to your baby during the pregnancy, while in labor, while giving birth, or by breastfeeding. You will have many choices to make about lowering the risk of passing HIV to your baby.
If you want to become pregnant, talk to your doctor right away. Your doctor can tell you how HIV can affect your health or your unborn baby's health. Your doctor can tell you how to prepare for a healthy pregnancy. There are ways for you to get pregnant that will limit your partner's risk of HIV infection. You can ask your doctor about ways to get pregnant without having unprotected sex with your partner.
If you just found out you are pregnant, see your doctor right away. Find out what you can do to take care of yourself and to give your baby a healthy start to life.
With your doctor's help, you can decide on the best treatment for you and your baby before, during, and after the pregnancy. You should also take these steps before and during your pregnancy to help you and your baby stay healthy.

Take these steps to lower the risk of giving HIV to your baby

Just because you have HIV doesn't mean your child will get HIV. In the United States, before effective treatment was available, about 25 percent of pregnant HIV-positive mothers who didn't breastfeed and did not receive anti-HIV treatment in pregnancy passed the virus to their babies.
Today, the risk of giving HIV to your newborn is below 2 percent. But you and the baby must get the right HIV drugs at the right times. You also can't breastfeed. The steps below can lower the risk of giving HIV to your baby.
  • Get as healthy as possible before becoming pregnant.
  • Start HIV treatment before pregnancy if you need it for your own health. Or, you can start treatment during pregnancy to lower the risk of passing HIV to your baby. If you are already on treatment, do not stop, but do see your doctor right away. Some HIV drugs should not be used while you're pregnant. For other drugs, you may need a different dosage.
  • Make sure your baby is tested for HIV right after birth. Your doctor or clinic should be experienced in managing babies who have been exposed to HIV. They will tell you what follow-up tests your baby will need, and when.
  • Ask your doctor about starting treatment for your baby right away if your baby is diagnosed with HIV. This may require a number of tests and you may not know until he is 2 to 4 months old.
  • Until you know that your baby is HIV-positive or HIV-negative, ask your pediatric HIV specialist if your baby might benefit from anti-HIV medicines. New research shows that putting a newborn on a 2- or 3-drug anti-HIV medicine plan cuts the infant's risk of HIV by 50 percent (compared to using one drug only).
  • Ask your doctor about other medicines the baby may need to prevent opportunistic infections until you know for sure whether the baby has HIV.
Steps to lower the risk of giving HIV to your baby and have a healthy baby
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  • man and woman at doctor's office
    Step 1: Get prenatal care
    Get prenatal care. Going to your doctor before you get pregnant or as soon as you find out you're pregnant will help you to have a healthy pregnancy.

HIV/AIDS drugs and pregnancy

HIV-infected pregnant women should take HIV medicines. These medicines can lower the risk of passing HIV to a baby, and in some cases, improve the mother's own health. Research has shown that taking combination HIV drugs is better at preventing HIV in newborns than taking AZT alone.
If you haven't used any HIV drugs before pregnancy and are in your first trimester, your doctor will help you decide if you should start treatment. Some things you can talk about with your doctor include:
  • Nausea and vomiting early in your pregnancy may make it hard to start the HIV drugs.
  • It is possible the drugs may affect your developing fetus. Your doctor will guide you.
  • HIV is usually passed to a baby late in pregnancy or during delivery.
  • Studies show that treatment works best at preventing HIV in a baby if it is started before 28 weeks into pregnancy.
Talk to your doctor about your health and the pros and cons of delaying treatment.
If you are already taking HIV drugs and find out you're pregnant in the first trimester, talk to your doctor about sticking with your current treatment plan. Some things you can talk about with your doctor include:
  • Whether to continue or stop HIV treatment in the first trimester. Stopping HIV drugs could cause your viral load to go up. If your viral load goes up, the risk of infection also goes up. Your disease also could get worse and cause problems for your baby. So this is a serious decision to make with your doctor.
  • What potential effects your HIV medicines may have on the developing fetus.
  • Whether you are at risk of developing drug resistance. Stopping HIV drugs without a firm plan from your doctor can lead to drug resistance. That is when the drugs don't work anymore against HIV. Never stop the drugs on your own without an OK from your doctor.
During your pregnancy, you and your doctor will not just discuss whether you should keep taking your HIV medicines. Your doctor may need to adjust your type or dosage of medicines. Changing your treatment will depend on many factors:
  • Your CD4 count
  • Risk of disease progression
  • Use of HIV/AIDS drugs
  • How far along the pregnancy is
  • Your weight
  • What is known and not known about the effects of the drugs on the fetus
  • Best treatment for your own health with HIV
No one can tell you for sure if your baby will be born with HIV. You can help lower your baby's HIV risk and keep yourself healthy by getting regular prenatal care and closely following your HIV drug treatment plan. See Treatments for HIV/AIDS for more information on HIV medicines.
Learn more about parenting a child with HIV and learn more about HIV medications for children with HIV.

Paying for care while you're pregnant

If you are pregnant, Medicaid may pay for your prenatal care. If you are pregnant and HIV-positive, this program might pay for counseling, medicine to lower the risk of passing HIV to your baby, and treatment for HIV. Each state makes its own rules regarding health care assistance. If you don't think you qualify for assistance, check again. Under health care reform, Medicaid eligibility will expand to cover many more people starting in 2014. Also, you may be able to get Medicaid because the income limits will be raised for pregnant women to provide prenatal care and HIV treatment.
To find out if you meet the requirements, contact your local or county medical assistance, welfare, or social services office. If you are unable to find that number, search your state's department of health.

A short story: Heather and Stuart have a healthy baby

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  • pregnant women at doctor's office
    Heather and her boyfriend, Stuart, have been together for two years. This year, when Heather found out she was pregnant, she also learned that she is HIV-positive.
    Dr. Murphy: Hi Heather. Congratulations on your pregnancy! Your regular doctor told me that you and your boyfriend, Stuart, were both diagnosed with HIV. I have a lot of pregnant patients who have HIV. As long as we diagnose early and take the right steps, the baby has a very high chance of being born HIV-free.
    Heather: I would feel better knowing that I could do something to help make sure the baby will be healthy.

More information on pregnancy and HIV/AIDS

Explore other publications and websites

  • HIV and Pregnancy — This series of fact sheets explains how a mother who has HIV can lower the risk of passing the virus to her baby during and after pregnancy.
  • HIV Infection in Infants and Children — This publication describes HIV in children, including information about transmission and diagnosis. It also talks about the progression of the disease, signs and symptoms of pediatric HIV, and treatment of children with HIV/AIDS.
  • HIV/AIDS During Pregnancy (Copyright © American Pregnancy Association) — This Web page from the American Pregnancy Association answers questions about how HIV affects pregnancy.
  • Infant Feeding and HIV (Copyright © UNICEF) — This publication outlines the risks and benefits of breastfeeding for mothers with HIV. It provides advice on getting tested for HIV and ways a woman with HIV can provide the nutrition her baby needs without breastfeeding.
  • Mother-to-Child (Perinatal) HIV Transmission and Prevention — This fact sheet talks about mother-to-child HIV transmission during pregnancy, labor and delivery, and breastfeeding. It discusses how mothers can lower the risk of perinatal transmission of HIV.
  • National HIV and STD Testing Resources — This website has information and resources on HIV testing, including a national database of HIV testing sites. It also provides basic information about HIV/AIDS and behaviors that place a person at risk of infection.
  • Standby Guardianship (Copyright © Family Ties Project) — Standby guardianship allows parents to make future plans for their children without having to legally transfer decision-making power. This website provides information on the Standby Guardianship Act of 2002 in the District of Columbia and information and resources on similar legislation in other states.
  • Women, Children, and HIV (Copyright © UCSF, UMDNJ) — This website provides resources on the prevention and treatment of HIV infection in women and children for health workers, program managers, and policy makers in resource-limited settings.

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