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. Lisa Thorley

    Hi Engelly,

    If you’re asking if the risk to your child will increase if you have sex, the answer is no. For more info about pregnancy, please see here:

  2. Engelly

    Hey! I Found Out Tht I Am HIV Positive This Year January,coz Thats The Only Time I Started Going To The Clinic For My ANC! I Was 5 Months Pregnant And They Put Me On ARV Treatment ASAP And I Acceptd Evnthough I Was Shockd, I’m On Treatment Like Now.
    My Question Is… Me And My Partner Had Some Unprotected Intercouse Now & Then Before I Found Out Tht I Was Positive, Will It Effect My Baby Or Is My Baby On The Safe Side Coz I Started With The Treatment ASAP, And We Never Had Sex From Then On Till Now, Just Once Wth Protection?

  3. Lisa Thorley

    Hi Private,

    Atripla is perfectly safe to take when pregnant, it won’t cause any damage to your baby.

  4. Private

    Hi, what happen if you change the treatment i was drinking valutrip but the doctor gave me Atroiza and im pregnant….its wont harm my baby??

  5. Roy Trevelion

    Hi Karabo,

    As Angelina says on this Q&A, These meds will be good for your health and good for your baby too.

    But is there a reason why you haven’t been able to start your HIV treatment?

    The benefits of HIV treatment (called ART) are not just to your own health. Treating your HIV will reduce the risk of your baby becoming HIV positive to almost zero.

    It’s good to start ART soon. That’s because the aim of ART is to reduce HIV to such tiny levels that it’s undetectable in your viral load blood test. Being undetectable will reduce the risk to your baby to close to zero.

    Please see this guide to HIV pregnancy and women’s health.

    If you live in South Africa you can contact the Treatment Action Campaign at this contact link. They can give local support.

  6. Karabo

    Hi am 2 months pregnant and HIV positive and i havent start taking my treatments will my baby be infected if i don’t take treatment

  7. Roy Trevelion

    Hi Ally,

    Thank you very much for saying this. It’s really great to know that you’re doing so well.

    Best wishes,
    Roy

  8. Ally

    Hi I’m Ally!

    I just want commend the i-base team they are doing a great job, they have saved so many people including me…. when i 1st diagnosed with HIV i was so emotional in such a way that i wanted to abort the baby and kill myself, but through the i-base team ive managed to switch my mind away from the evil and negative thoughts… comments and responses saved my life, its been almost 4 years now since taking my meds, thank you guys, and thank you so much that you are accessible to all over the world!

    Regards
    Ally

  9. Lisa Thorley

    Hi Nothando,

    i-base are based in the UK so I can’t tell you what the procedure will be with regards to accessing care in the country that you live in. You’ll need to talk to your HIV doctor about this. Ideally they should also consult the doctor who is overseeing your pregnancy.

    Given that you’re pregnant, it’s important that you starts meds ASAP. As to which meds you’ll be offered this will depend on where it is that you live. There’s more about pregnancy here: http://i-base.info/guides/pregnancy

  10. Nothando

    Im close to 5 months pregnant n recently found out dat Im HIV positive, so my question is when can I start taking the meds so that my baby doesnt get infected also what meds must I take to protect my baby from the virus.Through medical aid does my Gynae/ Dr apply for the meds or must I apply for the meds myself.?
    Also in terms of monthly visits what is the difference if I do my monthly check-ups at the clinic compared to visits to your Gnae/Dr.

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