Reducing the risk of HIV transmission to the baby

Reducing the risk of HIV transmission to the baby

Antenatal testing for HIV and early diagnosis and taking HIV treatment can help to reduce the risk of passing HIV to your baby.

There are two ways in which HIV treatment reduces the risk of you passing on HIV to your baby.

Firstly, HIV treatment reduces your viral load – the level of virus in your blood – so that your baby is exposed to less of the virus while in the womb and during birth. The aim of HIV treatment is to get your viral load below 50 copies/ml. This is often referred to as an undetectable viral load. Having an undetectable viral load means that HIV is still in your body, but at a much lower level.

Second, some anti-HIV drugs can also cross the placenta and enter your baby’s body where they can prevent the virus from taking hold. This is also why newborn babies are given a short course of anti-HIV drugs (this is called PEP, or post-exposure prophylaxis) after they have been born, if their mother is HIV-positive.

A number of factors may make it more likely that you will pass on HIV to your baby. These include:

During pregnancy

• Being ill because of HIV.
• Having a high HIV viral load or a low CD4 cell count.
• Having a sexually transmitted infection. You should have a sexual health screen early in your pregnancy and another one at 28 weeks.
• Having used recreational drugs, particularly injected drugs.

During delivery

• Your waters breaking four or more hours before delivery.
• Having an untreated sexually transmitted infection when you give birth.
• If you have a vaginal delivery (rather than a caesarean delivery) when you have a detectable viral load.
• If you have a difficult delivery; for example, forceps need to be used.
• If you have a premature baby.

After delivery

• To avoid passing HIV to your baby, it is safest to formula feed because breast milk can contain virus. Help should be available with getting formula milk and feeding equipment. Ask your healthcare team about this and how to protect your confidentiality if a friend or family member asks why you are not breastfeeding.