FACT SHEETS
 

HIV and Pregnancy 

HIV Testing and Pregnancy 

Mother-to-Child Transmission of HIV 

Anti-HIV Medications for Use in Pregnancy 

Safety of Anti-HIV Medications During 

Pregnancy 

Preventing Transmission of HIV During 

Labor and Delivery 

Women Infected with HIV and Their Babies 

After Birth Telephone: 1-800-448-0440 

International: 1-301-315-2816 

E-mail: contactus@aidsinfo.nih.gov 

Web: http://aidsinfo.nih.gov 
HIV and Pregnancy
 

These fact sheets on HIV and pregnancy are intended for women infected with HIV who are pregnant or thinking about becoming pregnant. The fact sheets include information to help women infected with HIV stay healthy during pregnancy and reduce the risk of transmitting HIV to their babies. 

The information in these fact sheets is based on the Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1­

Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. The 

Guidelines are developed by the U.S. Department of Health and Human Services (HHS) Panel on Treatment of HIV-Infected 

Pregnant Women and Prevention of Perinatal Transmission, a working group of the Office of AIDS Research Advisory Council 

(OARAC). The Guidelines are updated according to the latest advances in the management of HIV in pregnant women and 

the prevention of mother-to-child transmission of HIV. The current Guidelines are available on the AIDSinfo website at 

http://aidsinfo.nih.gov/guidelines. 

These fact sheets are not intended as a substitute for the expert advice and care of medical professionals. For individualized 

treatment, pregnant women infected with HIV should consult with a health care provider experienced in managing HIV during pregnancy. 

Table of Contents 

1. HIV Testing and Pregnancy 

2. Mother-to-Child Transmission of HIV 

3. Anti-HIV Medications for Use in Pregnancy 

4. Safety of Anti-HIV Medications During Pregnancy 

5. Preventing Transmission of HIV During Labor and Delivery 

6. Women Infected with HIV and Their Babies After Birth 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – HIV Testing and Pregnancy
 

HIV Testing and Pregnancy
 

I am pregnant. Will I be tested for HIV? 

HIV testing is recommended for all pregnant women. HIV 

testing is provided to pregnant women in two ways: opt-in 

or opt-out testing. In areas with opt-in testing, women may 

be offered HIV testing. Women who accept testing will need 

to sign an HIV testing consent form. In areas with opt-out 

testing, HIV testing is automatically included as part of routine prenatal care. With opt-out testing, women must specifically ask not to be tested and sign a form refusing HIV 

testing. The Centers for Disease Control and Prevention 

(CDC) recommends that opt-out testing be provided to all 

pregnant women. 

Ask your health care provider about HIV testing in your 

area. If HIV opt-out testing is not available, ask to be tested 

for HIV. 

What are the benefits of HIV testing for pregnant women? 

A mother who knows early in her pregnancy that she is HIV 

infected has more time to make important decisions. She and 

her health care provider will have more time to decide on effective ways to protect her health and prevent mother-tochild transmission of HIV. She can also take steps to 

prevent passing HIV to her partner. (See the Preventing HIV 

Transmission fact sheet.) 

How will I be tested for HIV? 

The most common HIV test is the HIV antibody test. HIV 

antibodies are a type of protein the body produces in response 

to HIV infection. An HIV antibody test looks for HIV antibodies in a person’s blood, urine, or fluids from the mouth. 

When a person has a positive result from an HIV antibody test, 

a second and different type of antibody test is done to confirm 

that the person is indeed infected with HIV. The second test is 

called a confirmatory HIV test. To be diagnosed with HIV, a 

person’s confirmatory HIV test must also be positive. (For 

more information, see the Testing for HIV fact sheet.) 

Getting results from an HIV antibody blood test generally 

takes only a few days. (Results from some tests that use fluids 

from the mouth are ready within an hour.) Getting results 

from a confirmatory HIV test can take longer—from a few 

days to a few weeks after the test. People generally receive 

their results during a follow-up visit with a health care 

provider. It is important to keep your appointment for your 

HIV test results. 

Terms Used in This Fact Sheet: 

Mother-to-child transmission of HIV: the passing of HIV 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 

HIV antibody test: an HIV test that checks for HIV antibodies in a person’s blood, urine, or fluids from the 

mouth. When the body is infected with HIV, the immune 

system (the system of the body that fights off infections) 

produces HIV antibodies. 

Pregnant women who test positive for HIV have many options to stay healthy and protect their babies from becoming 

HIV infected. Health care providers recommend that women 

infected with HIV take anti-HIV medications to prevent 

mother-to-child transmission of HIV and, if needed, for 

their own health. 

If you are diagnosed with HIV, your health care provider will 

answer your questions about HIV and discuss ways to help 

you and your baby stay healthy. Together you can make decisions about HIV care during your pregnancy. 

What happens if I ask not to be tested for 

HIV? 

You will not be tested for HIV. However, your health care 

provider will likely re-emphasize the importance of HIV testing. You may be offered counseling on how HIV is spread 

and ways to prevent HIV transmission. Throughout your 

pregnancy, your health care provider may encourage you to 

reconsider your decision not to be tested. 

Where can I find information on HIV testing 

in my state? 

The U.S. Department of Health and Human Services (HHS) 

offers information on HIV testing for each state. Contact 

HHS at 1–877–696–6775 or 1–202–619–0257. You can also 

find information on your state health department website. 

For more information: 

Contact an AIDSinfo health information specialist at 1– 

800–448–0440 or visit http://aidsinfo.nih.gov. See your 

health care provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Mother-to-Child Transmission of HIV 

Mother-to-Child Transmission of HIV 

How is HIV transmitted? 

HIV is transmitted (passed) from one person to another 

through specific body fluids—blood, semen, genital fluids, 

and breast milk. Having unprotected sex or sharing needles 

with a person infected with HIV are the most common ways 

HIV is transmitted. 

Mother-to-child transmission of HIV is when a woman 

infected with HIV transmits HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. Because HIV can be transmitted through breast milk, women 

infected with HIV should not breastfeed their babies. In the 

United States, baby formula is a safe and healthy alternative 

to breast milk. 

Although the risk is very low, HIV can also be transmitted to 

a baby through food that was previously chewed (prechewed) by a mother or caretaker infected with HIV. To be 

safe, babies should not be fed pre-chewed food. 

HIV cannot be transmitted through casual contact, such as 

hugging and closed-mouth kissing. HIV also cannot be 

transmitted by items such as toilet seats, door knobs, or 

dishes used by a person infected with HIV. 

When are anti-HIV medications used to prevent mother-to-child transmission of HIV? 

Anti-HIV medications are used at the following times to reduce the risk of mother-to-child transmission of HIV: 

• During pregnancy, pregnant women infected with HIV receive a regimen (combination) of at least three different 

anti-HIV medications. 

• During labor and delivery, pregnant women infected with 

HIV receive intravenous (IV) AZT and continue to take 

the medications in their regimens by mouth. 

• After birth, babies born to women infected with HIV receive liquid AZT for 6 weeks. (Babies of mothers who did 

not receive anti-HIV medications during pregnancy may be 

given other anti-HIV medications in addition to AZT.) 

In addition to taking anti-HIV medications to reduce the 

risk of mother-to-child transmission of HIV, a pregnant 

woman infected with HIV may also need anti-HIV medications for her own health. Some women may already be on a 

regimen before becoming pregnant. However, because during 

pregnancy some anti-HIV medications may not be safe to 

use or may be absorbed differently by the body, the medicaTerms Used in This Fact Sheet: 

Unprotected sex: sex without using a condom. 

Mother-to-child transmission of HIV: the passing of HIV 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 

Regimen: Anti-HIV medications are grouped into 

“classes” according to how they fight HIV. A regimen is a 

combination of three or more anti-HIV medications from 

at least two different classes. 

Intravenous (IV): to give a medication through a needle 

directly into a vein. 

AZT: an anti-HIV medication in the nucleoside reverse 

transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV. 

Placenta (also called the afterbirth): tissue that develops 

within the mother’s uterus during pregnancy to provide 

the baby with oxygen and nutrition. 

tions in a woman’s regimen may change. 

How do anti-HIV medications help prevent 

mother-to-child transmission of HIV? 

Taking anti-HIV medications during pregnancy reduces the 

amount of HIV in an infected mother’s body. Having less 

HIV in the body reduces the risk of mother-to-child transmission of HIV. 

Some anti-HIV medications also pass from the pregnant 

mother to her unborn baby through the placenta (also 

called the afterbirth). The anti-HIV medication in the 

baby’s body helps protect the baby from HIV infection. This 

is especially important during delivery when the baby may be 

exposed to HIV in the mother’s genital fluids or blood. 

After birth, babies born to women infected with HIV receive 

anti-HIV medication. The medication reduces the risk of infection from HIV that may have entered the babies’ bodies 

during delivery. 

For information on what anti-HIV medications to take during pregnancy, see the Anti-HIV Medications for Use in 

Pregnancy fact sheet. 

For more information: 

Contact an AIDSinfo health information specialist at 1– 

800–448–0440 or visit http://aidsinfo.nih.gov. See your 

health care provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Anti-HIV Medications for Use in Pregnancy
 

Anti-HIV Medications for Use in Pregnancy
 

I am HIV infected and pregnant. When should 

I start taking anti-HIV medications? 

• the potential of anti-HIV medications to harm your baby 

or cause birth defects. 

When to start taking anti-HIV medications depends on your 

health, how much HIV has affected your body, and how far 

along you are in your pregnancy. In general, people infected 

with HIV who are not pregnant begin taking anti-HIV medications when their CD4 counts fall below 500 cells/mm3 or 

if they develop certain other infections. (See the When to 

Start Anti-HIV Medications fact sheet.) Pregnant women infected with HIV must also consider whether they need antiHIV medications for their own health or only to prevent 

mother-to-child transmission of HIV. 

Women who need anti-HIV medications for their own 

health: 

• may be taking anti-HIV medications before becoming 

pregnant; or 

• may start taking anti-HIV medications when they become 

pregnant. 

Women who need anti-HIV medications only to prevent 

mother-to-child transmission of HIV can consider waiting 

until after the first trimester of pregnancy to take anti-HIV 

medications. However, starting medications earlier may be 

more effective at reducing the risk of mother-to-child transmission of HIV. 

All pregnant women infected with HIV should be taking 

anti-HIV medications by the second trimester of pregnancy. 

Women diagnosed with HIV later in pregnancy should start 

taking anti-HIV medications as soon as possible. 

What anti-HIV medications should I use during my pregnancy? 

All pregnant women infected with HIV should take a regimen (combination) of at least three anti-HIV medications. 

However, the specific medications in your regimen will depend on your individual needs. To select a regimen, your 

health care provider will review your medical history and 

order blood tests to assess your health and the stage of your 

HIV infection. Your health care provider will also consider: 

• why you need anti-HIV medications—for your own health 

or only to prevent transmitting HIV to your baby; 

• changes in how your body may absorb medications during 

pregnancy; and 

I am currently taking anti-HIV medications and 

just learned I’m pregnant. What should I do? 

Continue taking your anti-HIV medications until you talk to 

your health care provider. Stopping treatment could harm 

both you and your baby. 

If you are in the first trimester of pregnancy, tell your health 

care provider right away if you are taking Sustiva (or 

Atripla, an anti-HIV medication that contains Sustiva). Sustiva alone or in Atripla may cause birth defects that develop 

during the first few months of pregnancy. Your health care 

provider may recommend safe alternatives for these medications. After the first trimester, Sustiva or Atripla can be used 

safely. 

Terms Used in This Fact Sheet: 

CD4 count: CD4 cells, also called T cells or CD4+ T cells, 

are white blood cells that fight infection. HIV destroys 

CD4 cells, making it harder for the body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood. A CD4 count measures how well your 

immune system is working. 

Mother-to-child transmission of HIV: the passing of HIV 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 

Regimen: Anti-HIV medications are grouped into 

“classes” according to how they fight HIV. A regimen is a 

combination of three or more anti-HIV medications from 

at least two different classes. 

Sustiva: an anti-HIV medication in the NNRTI class. Sustiva is also called efavirenz or EFV. 

Atripla: a combination of three anti-HIV medications in 

one pill—Sustiva (also called efavirenz or EFV), Emtriva 

(also called emtricitabine or FTC), and Viread (also called 

tenofovir or TDF). 

Viral load: the amount of HIV in a sample of blood. Viral 

load measures how much virus you have in your body 

and how well anti-HIV medications are controlling the infection. 

Drug-resistance testing: a blood test to identify which, if 

any, antiretroviral (ARV) drugs will not be effective against 

a person's specific strain of HIV. Resistance testing is 

done using a sample of blood. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Anti-HIV Medications for Use in Pregnancy
 

Talk to your health care provider about the anti-HIV medications in your regimen. Because pregnancy can affect how the 

body absorbs medications, the doses of some medications you 

take may change later in pregnancy. 

If you are taking anti-HIV medications and your viral load is 

more than 500 copies/mL, your current regimen may not be 

effective at suppressing HIV. Your health care provider will 

recommend a test to see if the medications are still working 

against HIV (drug-resistance testing) and use the test results to find more effective anti-HIV medications. 

I used to take anti-HIV medications, but I 

don’t anymore. What should I do? 

Talk to your health care provider about all anti-HIV medications you have used, the results of past drug-resistance testing, 

and why you no longer take anti-HIV medications. Your 

medical history, past drug-resistance test results, and additional drug-resistance testing will help you and your health 

care provider select a new regimen that is safe for use during 

pregnancy. 

Whether you were on anti-HIV medications before becoming 

pregnant or are just starting a regimen, your health care 

provider will: 

• explain the risks and benefits of using anti-HIV medications during pregnancy; 

• stress the importance of taking anti-HIV medications exactly as directed; and 

• arrange for additional medical or social support you may 

need to help you have a healthy pregnancy. 

For more information: 

Contact an AIDSinfo health information specialist at 1–800– 

448–0440 or visit http://aidsinfo.nih.gov. See your health 

care provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Safety of Anti-HIV Medications During Pregnancy 

Safety of Anti-HIV Medications During Pregnancy
 

I am HIV infected and pregnant. Is it safe to use 

anti-HIV medications during my pregnancy? 

Women infected with HIV can safely use many anti-HIV 

medications during pregnancy to protect their health and to 

prevent transmitting HIV to their babies. However, some 

anti-HIV medications can cause problems when used during 

pregnancy. Knowing more about the safety of anti-HIV 

medications and pregnancy will help you and your health 

care provider decide what medications are right for you. 

Is my baby at risk from anti-HIV medications 

I take during pregnancy? 

It’s not known if babies will have any long-term effects from 

the anti-HIV medications their mothers use during pregnancy. However, the risk of mother-to-child transmission 

of HIV is known. And the illness that results when HIV infection is passed from a mother to her child is very real. Because anti-HIV medications can greatly reduce the risk of 

passing HIV infection from a mother to her child during 

pregnancy, all pregnant women infected with HIV should 

take anti-HIV medications. 

Information on the use of anti-HIV medications during pregnancy is limited. But enough information is known to make 

recommendations about the safety of the most commonly used 

medications from the three most commonly used classes of 

anti-HIV medications—protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and nucleoside reverse transcriptase inhibitors (NRTIs). (Not 

enough information is known to make recommendations 

about use during pregnancy of entry inhibitors and integrase 

inhibitors, two additional classes of anti-HIV medications.) 

Protease inhibitors (PIs) 

There may be a link between the use of some PIs and high 

blood sugar (hyperglycemia) or diabetes. For some women, 

the risk of hyperglycemia increases in pregnancy. It is unclear 

if taking PIs adds to this risk. Talk to your health care provider 

about the use of PIs during pregnancy and about when to 

have blood tests to check for hyperglycemia or diabetes. 

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) 

Terms Used in This Fact Sheet: 

Mother-to-child transmission of HIV: the passing of HIV 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 

Protease inhibitor (PI): a class of anti-HIV medications. PIs 

block HIV protease, an enzyme HIV needs to make copies of 

itself. 

Non-nucleoside reverse transcriptase inhibitor (NNRTI): a 

class of anti-HIV medications. NNRTIs bind to and alter reverse transcriptase, an enzyme HIV needs to make copies 

of itself. 

Nucleoside reverse transcriptase inhibitor (NRTI): a class of 

anti-HIV medications. NRTIs block reverse transcriptase, an 

enzyme HIV needs to make copies of itself. 

Entry inhibitor: a class of anti-HIV medications. Entry inhibitors block CCR5 , a protein on the CD4 cells that HIV 

needs to enter the cells. 

Integrase inhibitor: a class of anti-HIV medications. Integrase inhibitors work by blocking HIV integrase, a protein 

HIV needs to make copies of itself. 

Hyperglycemia: too much glucose (sugar) in the blood. 

Diabetes (also known as diabetes mellitus): high levels of 

glucose (sugar) in the blood. 

Sustiva: an anti-HIV medication in the NNRTI class. Sustiva 

is also called efavirenz or EFV. 

Viramune: an anti-HIV medication in the NNRTI class. Viramune is also called nevirapine or NVP. 

Atripla: a combination of three anti-HIV medications in one 

pill—Sustiva (also called efavirenz or EFV), Emtriva (also 

called emtricitabine or FTC), and Viread (also called tenofovir or TDF). 

CD4 count: CD4 cells, also called T cells or CD4+ T cells, are 

white blood cells that fight infection. HIV destroys CD4 cells, 

making it harder for the body to fight infections. A CD4 count 

is the number of CD4 cells in a sample of blood. A CD4 

count measures how well your immune system is working. 

Lactic acidosis: a condition caused by too much lactic acid 

in the blood. 

Zerit: an anti-HIV medication in the NRTI class. Zerit is also 

called stavudine or d4T. 

Videx: an anti-HIV medication in the NRTI class. Videx is 

also called didanosine or ddI. 

Two NNRTIs, Sustiva and Viramune, should be used in first few months of pregnancy. Therefore, if possible, use of pregnant women only under certain conditions. Sustiva should be avoided in the first trimester of pregnancy. Atripla, a combination pill that contains Sustiva, • Sustiva may cause birth defects that develop during the 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Safety of Anti-HIV Medications During Pregnancy
 

should also be avoided in the first trimester of pregnancy. 

After the first trimester, Sustiva or Atripla can be used safely. 

• Viramune increases the risk of very serious liver damage in 

women with CD4 counts greater than 250 cells/mm3

. Viramune should only be started in pregnant women with 

CD4 counts higher than 250 cells/mm3 if the benefits very 

clearly outweigh the risks. Women who begin using Viramune during pregnancy are carefully monitored for early 

signs of liver damage. Women taking Viramune without 

problems before they become pregnant can safely continue 

to take the medication. Liver damage from Viramune use in 

pregnancy has not been seen in women already taking the 

medication without side effects. 

Nucleoside reverse transcriptase inhibitors 

(NRTIs) 

Using NRTIs can sometimes lead to lactic acidosis, a condition caused by the buildup of a specific acid in the blood. 

Women should not take the combination of Zerit and 

Videx during pregnancy because the combination has 

caused deaths from lactic acidosis and liver failure. Women 

taking NRTIs during pregnancy are watched carefully for 

signs of lactic acidosis. 

Talk to your health care provider about the safety of anti-HIV 

medications during pregnancy. There are many anti-HIV 

medications to choose from that will keep you and your baby 

healthy. 

For more information: 

Contact an AIDSinfo health information specialist at 1–800– 

448–0440 or visit http://aidsinfo.nih.gov. See your health 

care provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Preventing Transmission of HIV During Labor and Delivery
 

Preventing Transmission of HIV During Labor and Delivery
 

I am HIV infected and pregnant. Will I need 

anti-HIV medications during labor and 

delivery? 

Women infected with HIV take anti-HIV medications during labor and delivery to reduce the risk of mother-to-child 

transmission of HIV. (See the Mother-to-Child Transmission of HIV fact sheet.) During labor and delivery, women 

continue to take the anti-HIV medications they took 

throughout their pregnancies. They also receive an anti-HIV 

medication called AZT intravenously to protect their babies from HIV in the mother’s genital fluids or blood during 

labor and delivery. 

Talk to your health care provider about the use of anti-HIV 

medications during labor and delivery well before your due 

date. 

Will I have a vaginal or a cesarean delivery? 

The risk of mother-to-child transmission of HIV is low for 

women who take anti-HIV medications during pregnancy 

and have a viral load less than 1,000 copies/mL near the 

time of delivery. 

For some HIV-infected mothers, a scheduled cesarean delivery (also called a C-section) at 38 weeks of pregnancy 

(2 weeks before the due date) can reduce the risk of motherto-child transmission of HIV. A scheduled cesarean delivery 

is recommended for HIV-infected women who: 

• have not received anti-HIV medications during pregnancy; 

• have a viral load greater than 1,000 copies/mL or an unknown viral load near the time of delivery. 

If, before her scheduled cesarean delivery, a woman’s water 

breaks (also called rupture of membranes) or she goes into 

labor, a cesarean delivery may not reduce the risk of motherto-child transmission of HIV. If there is not another pregnancy-related reason to have a cesarean delivery, the risks of 

going ahead with the scheduled cesarean delivery may be 

greater than the benefits. Depending on an individual 

woman’s situation, a vaginal delivery may be the best alternative to a planned cesarean delivery. 

What are the risks of delivery? 

All deliveries have risks—even for mothers without HIV infection. In general, a cesarean delivery has greater risks than a 

vaginal delivery. 

Terms Used in This Fact Sheet: 

Mother-to-child transmission of HIV: the passing of HIV
 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 


AZT: an anti-HIV medication in the nucleoside reverse
 

transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV.
 

Intravenously: giving a medication directly into a vein
 

through a needle. 


Viral load: the amount of HIV in a sample of blood. 


Cesarean delivery (C-section): delivery of a baby by a surgical incision through the mother's abdominal wall and
 

uterus. 


Rupture of membranes: when the amniotic sac (“bag of
 

waters”) holding the unborn baby bursts. Also called
 

“water breaking.” 


For the mother, the risk of infection or a blood clot in the 

legs or lungs is greater with a cesarean delivery than with a 

vaginal delivery. All women who have a cesarean delivery, including women infected with HIV, should receive antibiotics 

to prevent infection. For the infant, the risk of temporary 

breathing difficulties may be greater with a cesarean delivery. 

Talk to your health care provider about the risks and benefits 

of each type of delivery early in your pregnancy. 

For more information: 

Contact an AIDSinfo health information specialist at 

1–800–448–0440 or visit http://aidsinfo.nih.gov. See your 

health care provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Women Infected with HIV and Their Babies After Birth
 

Women Infected with HIV and Their Babies After Birth
 

I am HIV infected and pregnant. What are the 

chances my baby will be born with HIV? 

In the United States and Europe, fewer than 2 babies in 100 

born to mothers infected with HIV are infected with the 

virus. This is because most women infected with HIV and 

their babies receive anti-HIV medications to prevent motherto-child transmission of HIV and do not breastfeed. If you 

take anti-HIV medications during pregnancy and labor and 

delivery, if your baby receives anti-HIV medications after 

birth, and if you do not breastfeed your baby, the risk of 

passing HIV to your baby is very low. 

Will my newborn baby receive anti-HIV 

medications? 

Yes. Within 6 to 12 hours after delivery, babies born to 

women infected with HIV receive an anti-HIV medication 

called AZT. AZT helps prevent mother-to-child transmission 

of HIV. The babies receive AZT for 6 weeks. (In certain situations, some babies may receive other anti-HIV medications in 

addition to AZT.) 

When will my baby be tested for HIV? 

HIV testing for babies born to women with known HIV infection is recommended at 14 to 21 days, at 1 to 2 months, 

and again at 4 to 6 months. Testing for babies is done using a 

virologic HIV test. Virologic HIV tests look directly for the 

presence of HIV in the blood. 

• To be diagnosed with HIV, a baby must have positive results from two virologic HIV tests. 

• To know for certain that a baby is not infected with HIV, 

the baby must have two negative virologic HIV tests, the 

first at 1 month of age or older, and the second at least 1 

month later. 

Babies who are HIV-infected receive a combination of antiHIV medications to treat HIV. At 4 to 6 weeks of age, babies 

infected with HIV also start a medication called Bactrim. 

(Bactrim is also given as a precaution when it’s not known if 

a baby is HIV infected or not.) Bactrim helps prevent Pneumocystis jiroveci pneumonia (PCP), a type of pneumonia 

that can develop in people with advanced HIV. 

What is the best way to feed my baby? 

Because HIV can be transmitted through breast milk, women 

Terms Used in This Fact Sheet: 

Mother-to-child transmission of HIV: the passing of HIV
 

from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding. 


AZT: an anti-HIV medication in the nucleoside reverse
 

transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV.
 

Virologic HIV test: a laboratory test that measures the
 

amount of HIV in a sample of blood. 


Bactrim: an antibiotic used to prevent and treat infection
 

with Pneumocystis jirovecii pneumonia (PCP). Bactrim is
 

also called Septra, Sulfatrim, Sulfamethoxazole/
 

Trimethoprim, or TMP-SMX. 


Pneumocystis jiroveci pneumonia (PCP): a lung infection
 

caused by a fungus that occurs in people with weakened
 

immune systems. 


Regimen: Anti-HIV medications are grouped into
 

“classes” according to how they fight HIV. A regimen is a
 

combination of three or more anti-HIV medications from
 

at least two different classes
 

CD4 count: CD4 cells, also called T cells or CD4+ T cells,
 

are white blood cells that fight infection. HIV destroys
 

CD4 cells, making it harder for the body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood. A CD4 count measures how well the
 

immune system is working. 


Viral load: the amount of HIV in the blood. 


infected with HIV who live in the United States should not 

breastfeed. In the United States, infant formula is a safe and 

healthy alternative to breast milk. Although the risk is very 

low, HIV can be transmitted to a baby through food that was 

previously chewed (pre-chewed) by a mother or caretaker infected with HIV. To be safe, babies should not be fed prechewed food. 

Will my anti-HIV medications change after I 

give birth? 

After your baby is born, you and your health care provider 

may decide to stop or change your anti-HIV regimen. The 

decision to continue, change, or stop your anti-HIV medications will depend on several factors: 

• current expert recommendations on the use of anti-HIV 

medications 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines). 
HIV and Pregnancy – Women Infected with HIV and Their Babies After Birth
 

• your CD4 count and viral load 

• issues that make it hard to take medications exactly as directed 

• whether or not your partner is infected with HIV 

• the preferences of you and your health care provider 

Don’t stop taking any of your anti-HIV medications without 

first talking to your health care provider. Stopping your medications may limit the number of anti-HIV medications that 

will work for you and may cause your HIV infection to 

worsen. 

Having a new baby is exciting! However, caring for a new 

baby while dealing with the physical and emotional changes 

that follow childbirth can be stressful. It may be difficult to 

take your anti-HIV medications exactly as directed. If you feel 

sad or overwhelmed or have concerns about taking your medications, talk to your health care provider. Together you can 

make a plan to keep you and your baby healthy. 

For more information: 

Contact an AIDSinfo health information specialist at 1–800– 

448–0440 or visit http://aidsinfo.nih.gov. See your health care 

provider for medical advice. 

This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use Reviewed 

of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce February 2012 

Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines).