Introduction
This guide is about HIV and pregnancy.
It explains what to do if you are diagnosed with HIV in pregnancy. It also explains what to do if you already know you are HIV positive and decide to have a baby.
The guide includes information about:
- mothers’ health, using antiretrovirals during pregnancy and the babies’ health.
- how to have an HIV negative baby if you are HIV positive.
- safe conception for couples were one partner is positive and one is negative.
This is the 5th edition of the i-Base pregnancy guide.
Since our last edition, research findings have been reported that have informed a few changes in our guide. These include:
- An expanded section on safe conception for couples where one partner is HIV negative and one is HIV positive. This has more emphasis on safer natural conception. So although most of the information included in the booklet is for HIV positive women, this section is also relevant to HIV negative women with HIV positive men.
- That it is less important and likely that you will receive the drug AZT in your combination.
- A stronger emphasis on making sure your viral load is undetectable at delivery. Also more details about when to start treatment to ensure that you achieve this for different viral load levels.
- More information on safety and side effects of anti-HIV drugs. Including on the protease inhibitor atazanavir that is increasingly being used in pregnancy.
- A strong recommendation that all pregnant women should be vaccinated against flu.
- A continued strong recommendation on the importance of complete avoidance of breast feeding despite new research relevant to countries where this is not possible.
- We have also included some personal stories.
- The excellent news is, with good management focusing on a woman’s health and choice, there is little risk of transmission to her child for an HIV positive mother delivering in the UK today.
Our most recent reports show a 1 in 1,000 transmission rate for women receiving HAART with an undetectable viral load of less than 50 copies/mL whether she has a planned vaginal or planned Caesarean delivery.
This is the lowest reported and represents a significant advance in the information available to women planning a family or already pregnant.
We explain what all these options mean and when they are appropriate.
Excellent news too is that people with HIV are living longer and healthier lives so an HIV positive mother in the UK today can also expect to be around to watch her child grow up!
British HIV Association (BHIVA) and Children’s HIV Association (CHIVA) Guidelines for the Management of HIV Infection in Pregnant Women 2008 are online at:
http://www.bhiva.org/PregnantWomen2008.aspx
British HIV Association, BASHH and FSRH guidelines for the management of the sexual and reproductive health of people living with HIV infection 2008 are online at:
http://www.bhiva.org/documents/Guidelines/Sexual%20health/Sexual-reproductive-health.pdf
Some of the research we discuss in this booklet has been reported since the guidelines were published, but they are currently being revised. What we talk about reflects the treatment you should expect in the UK in 2011.