Levine explained that this was originally thought by many to be premature menopause in which ovarian function wanes and eventually ceases. The role of HIV in this theory was not understood. The levels of FSH detected in HIV-positive women experiencing amenorrhea do not indicate true menopause. Despite data on the lack of toxicity of many anti-HIV medications to the fetus, Levine asserts that medical management of the woman patient should be the paramount concern of physicians and combination therapy utilized if indicated. Because of the demonstrated efficacy of AZT in reducing the likelihood of perinatal transmission, women who remain on combination therapy throughout their entire pregnancies should consider adding that drug into their regimen until delivery.
Medications fall into four risk categories when considering damage to a developing fetus.
Levine also stated that exposure to AZT intravenously during labor may be a highly critical point of intervention for women who have taken no medication at all. Following Levine's presentation, a woman living with AIDS reviewed her nine-year history of antiretroviral treatment and discussed her relationship with medical providers. Hearing the patient's perspective highlighted for the audience the importance of individualizing treatment strategies. Women and men with HIV may not differ clinically as much as one would expect, but no two patients are alike.