World AIDS day takes place on December 1 every year. It is an opportunity to remember those we have lost to HIV, support those living with HIV, and continue to fight to end HIV. According to the CDC, 1.1 million people are living with HIV and as many as one in seven people with HIV do not know they are infected. Pregnancy represents an important time to screen for infections and other conditions that can impact a person’s future. In fact, pregnancy is often the only time a person may see a doctor. For this reason, people are tested for HIV, and many other conditions, during pregnancy.
Decreasing perinatal transmission of HIV—preventing passing the virus from parent to child—has been one of the largest public health achievements of the last 20 years. In the beginning of the HIV epidemic, up to 7,000 children were born HIV-positive each year. Thanks to improvement in screening and treatment, only 100 to 300 children are born HIV-positive each year. This number is still too high; with our current prevention and treatment methods, this number should be zero.
When a pregnant person is HIV-positive and not taking antiretroviral medicine, they have a 15 to 45 percent chance of passing the virus to their child. However, with treatment throughout pregnancy, delivery, and breastfeeding, the risk of transmission is less than one percent. The chance of a child being born HIV-positive is directly related to the amount of virus in the parent’s blood at the time of delivery. This is why early detection is so important; it gives medications time to work before the child is born. Antiretroviral medications are safe to take during pregnancy. If the amount of HIV virus is low, the pregnancy is just like any other pregnancy. In rare cases, a C-section is needed to help decrease the risk of transmission to the child.
Just as important as detection and treatment is planning a pregnancy and making sure the person is ready to conceive. All people should have HIV testing at least once in their reproductive life and yearly if engaging in high risk behavior that includes unprotected intercourse and intravenous drug use. In people who are HIV-positive, it is important to stay on medications while trying to conceive and throughout the pregnancy. If a person not planning a pregnancy, there are many contraceptive options that are safe and effective.