Reducing the Transmission of HIV to Infants

There are several possible decisions a woman can make to try to reduce the chances of passing HIV to her baby. Some of these decisions can have a big effect on reducing the chances that an infant born to a woman infected with HIV will also be infected.

One of the most important decisions a pregnant woman with HIV will make is a decision on whether to take medicine for her infection during pregnancy. Current HIV treatment guidelines recommend that treatment decisions for pregnant women with HIV should be the same as non-pregnant adults. However, the guidelines recognize that women who are not being treated with HIV drugs may wish to delay treatment until after the first three months of pregnancy. There are reasons both in favor and against taking drugs for HIV treatment and/or prevention of HIV transmission from mother to child during pregnancy. It is important for a woman trying to make such a decision to talk to her health care provider about possible treatment options and the benefits and risks of each. After learning about options, she will need to make a decision with which she feels comfortable.

At this time, only one drug, AZT (also called Zidovudine , ZDV) is approved by the Food and Drug Administration (FDA) to help reduce transmission of HIV from the mother to her baby. However, some physicians are using other drugs. Some women may already be receiving treatment for their HIV infection with any of a variety of drugs when they find out they are pregnant. It is important for these women to discuss with their health care provider the risks and benefits of continuing, changing, or stopping medications.

TRANSMISSION OF HIV FROM MOTHER TO CHILD

If you are pregnant and are infected with HIV, you may pass the virus to your baby three ways:
1.During pregnancy,
2.During delivery, or
3.After delivery through breast feeding

Without taking prevention measures, the chances are about one in four that HIV will pass from a mother to her baby before or during birth. This is only an average. No one can tell you for sure what your baby’s chances are.

If you have HIV and are pregnant, the most important thing you can do is to see your health care provider early and often during your pregnancy. There are several options available for reducing the transmission of HIV to your baby–talk with your health care provider about what is most appropriate.

HIV PREVENTION

The following is a current option for preventing mother to child transmission of HIV that you should discuss with your health care provider.

AZT Prophylaxis

AZT is a medicine used to treat HIV infection and to prevent transmission of HIV from a pregnant woman to her child. With AZT, the chance that your baby will get HIV is lowered from about 3 out of 12 (25 percent) to 1 out of 12 (8 percent). Newer studies are showing that the chance of transmitting HIV to your baby may be reduced to as low as 3 out of 100 ( 3 percent) if you follow the advice of your health care provider, and that shorter drug regimens which may use drugs other than AZT may be effective in reducing the chances of transmitting HIV from the mother to the newborn if the full AZT regimen could not be taken. The full AZT regimen is still the standard of care for preventing HIV transmission from mother to the newborn, and should be used when at all possible to provide the most protection against transmission.

OTHER WAYS TO PROTECT YOUR BABY

In addition to the treatment option mentioned above, there are other ways to protect your baby that you may want to discuss with your health care provider. These include:
•Not breast feeding (HIV can pass to your baby through breast milk)
•Keeping yourself as healthy as possible through: ◦good nutrition (healthy foods and prenatal vitamin supplements as prescribed by your health care provider)
◦regular moderate exercise
◦adequate rest
◦early and regular prenatal care for your whole pregnancy

•Lowering the risk of transmitting HIV to your baby by: ◦not smoking,
◦refusing to do illegal drugs,
◦always using a condom when you have sex, even after becoming pregnant, and
◦not having multiple sex partners.