Q and A

Question

I’m 6 months pregnant. Is it safe to delay 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.

216 comments

  1. Roy Trevelion

    Hi Mra,

    First, congratulations on the news that you’re going to have a baby.

    Your doctor is right. That’s because the benefits of HIV treatment are not just to your own health. Treating your HIV will reduce the risk of your baby becoming HIV positive.

    Please see the guide to HIV pregnancy and women’s health. There’s a lot of info in this guide. It will help you talk to your doctor about your HIV treatment (called ART). And there’s also info about after your baby is born.

  2. mra

    I am five months pregnant woman n I find that I am HIV positive so the doctor advice me to take a treatement asap so does this affect my baby or not.my questions is the baby he’s still safe to test negative or already he’s positive?

  3. Roy Trevelion

    Hi Engelly,

    First, many congratulations on the news that you’re going to have a baby.

    It’s good too, to take ARVs when you’re pregnant up to and after giving birth. Women around the world have taken ARVs safely in pregnancy now for over 20 years. Millions of women have taken these ARVs. This has resulted in many healthy HIV negative babies.

    Having an undetectable viral load is the aim of HIV treatment (ART). So having a low viral load is great. Being on ART can reduce the risk of HIV to your baby to tiny levels.

    Please see the guide to HIV pregnancy and women’s health. There’s lots of info in this. Including for after your baby is born.

  4. Engelly

    Will My Child Test Positive Or Negative If I Miss Taking My ARVs While In Labour And During Birth! They Said My Viral Load Is Low!

  5. Lisa Thorley

    Hi Engelly,

    Missing a days worth of meds won’t have any impact on your viral load.

  6. Engelly

    Hi! I Forgot To Take My ARVs When I Was In Labour And During Birth, Will My Baby Test Positive Or Negative, Please Help?

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