Question
I’m 6 months pregnant. Is it safe to delay starting treatment?
5 February 2018. Related: All topics, Pregnancy, South Africa, Starting treatment.
I am 6 months pregnant and have just tested positive. My CD4 count is 256. I have to start now.
I didn’t get much info as I thought I am doing it for my baby but I find it difficult to deal with the fact that I have developed AIDS, and have to start treatment.
My question is, will it be dangerous for me to delay taking the treatment for myself and only take the one for the baby. Since I think it was my emotional state that made my CD to be low.
I am very healthy and eat well. Please advise.
Answer
Firstly, congratulations on your pregnancy.
I am sorry about your recent HIV diagnosis. I can appreciate that it cannot be easy dealing with a diagnosis during pregnancy and then knowing that you need to start taking treatment straight away. Can I ask if your doctor has put you in contact with support groups for people living with HIV? Many women find it helpful sharing experiences and coping with being HIV positive and pregnant.
Technically, a CD4 count of 256 doe not mean you have ‘AIDS’ as the US defines this as being less than 200, but it does mean starting treatment is very important.
Your doctor is giving you good advice. Starting treatment (ART) straight away is important.
The WHO (World Health Organisation) guidelines recommends all HIV positive pregnant women start ART. This is regardless of the CD4 count. These meds will be good for your health and good for your baby. The meds should get your viral load to undetectable befire your baby is born. Sometimes this takes longer than three months.
Viral load refers to the amount of virus in your body. An undetectable viral load (below 50 copies) means that there is very little virus in your body and is therefore the best way of preventing transmission to the baby.
Continuing ART afterwards is also recommended, but should be discussed with your doctor. As your CD4 count is 256, it is better to continue taking treatment after the baby is born.
The good news is that ART should increase your CD4 count. Although sometimes if you start taking treatment in pregnancy your CD4 count may not increase very much. If this happens, don’t worry, your CD4 count will catch up after the baby is born. For more information on HIV and pregnancy, please follow this link to our guide to HIV, pregnancy and women’s health. The guide also answers a lot of general questions about HIV and pregnancy.
It is good that you eat well and lead a healthy lifestyle. Avoiding stress, eating a balanced diet and taking exercise are all good for your general health and well being. However, this will not necessarily increase your CD4 count. ARVs are the only proven way of increasing and maintaining a good CD4 count.
As you are based in South Africa, you may find it useful to contact TAC (Treatment Action Campaign). They will be able to put you in contact with support groups near you. You may also find it useful to read TAC’s guide to Pregnancy in our lives.
Good luck for the rest of your pregnancy.
Note: This answer was updated in February 2018 from a question first posted online in April 2012.
Hi Zamokuhle,
As you’re pregnant its very important that you take your meds and take them as prescribed, so daily. If you don’t your viral load will struggle to remain undetectable and the risk of transmission to your baby will be greater.
As you’ve been off meds for a week, the best thing to do is to discuss this with your doctor. Let them know that you deflated. They may check your CD4 count as well as your viral load as well as run a resistance test.
Its not too late to restart, and you have plenty of time for your HIV to become under control. Please see here for more info about HIV and pregnancy:
http://i-base.info/guides/pregnancy
Hi I found out that am hiv+ last year and started taking my meds immediately.. then continued but I sometimes skipped taking my pills and now am a month pregnant and haven’t took them for about a week. What are the risks for me and my baby? What can I do to protect us and what’s gonna happened if I start taking my meds again??
Hi Beatrice.
Is there any reason why you aren’t taking ARVs? As a woman who is pregnant you should be on them. Not only will they control your HIV, they will also reduce the risk of transmission to your baby.
If you don’t take ARVs, you are risking the health of your child as they too could become positive.
Its not too late for you to start, you still have 2 months left of your pregnancy. Please see here for more info about HIV and pregnancy:
http://i-base.info/guides/pregnancy
Hi,I am 7months pregnant and positive and I am not taking ARVs is there any possibility that I can give birth to a negative child?
Hi Cleopatra,
Do you know what your viral load is? Has a birth plan been discussed with you?
Its not possible for anyone to say at this time if your baby will be negative or not. However, being on medication will help.
There’s more info here about HIV and pregnancy and what to expect when diagnosed late in pregnancy.
http://i-base.info/guides/pregnancy
Q:im 8 months pregnant and Im HIV positive.Ive only been on drugs for 1month 2weeks.How safe is my baby?
Hi Tops.
When a woman is pregnant and positive its very important that she takes ARVs. This is because its the ARVs that will reduce the risk of transmission. If you keep stopping and starting with your meds you risk developing resistance to your medication.
Do you know what your current viral load is? Have you discussed this issue with your doctor?
Am HIV positive and am 27weekd carring twins …and I’ve started taking ARVS whn I was 4mnths but some other time I don’t take mayb for 1weeks coz I vomited a lot the yellow thing but am taking them ..will my babby get affected if I don’t take since my due date is nearly ?
Hi Tebogo,
Its common to feel like this when you first start meds. What is it that you’re taking? Other than having issues with sleep, what are the other side effects?
As you’ve just started meds, you may find the following guide helpful:
http://i-base.info/guides/starting
You may also find our pregnacy guide helpful:
http://i-base.info/guides/pregnancy
Hi m 8 months preg nd diagnosed with hiv…I just started taking treatment 2 days ago nd the side effects are heavy I can’t sleep, pls advice on what can I do to lower side effects