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 Kedibone,
Your CD4 count is excellent, this is great to hear. Because you’ve been on meds for over 2 months, its very possible that your viral load will be undetectable. This is important as it will help reduce the risk of transmission. For more about HIV and pregnancy, please see here:
http://i-base.info/guides/pregnancy
Though not ideal, you should be OK even if you’ve missed 4 days of meds. However, its important that you begin them again as soon as you can.
The World Health Organisation recommendations are that women who are on treatment can breastfeed. Therefore, if this is something that you would like to do then you can.
Hi, I found out I am HIV on the 1/12/2016 (WORLS AIDS DAY). I was then 5 months pregnant with a CD4 count of 1752, CD4 CELL% 50.28.
I started ARV ASPEN LAMVID and ALUVIA immediately and never missed/ defaulted on taking them until recently when my medical aid delayed in delivering my ARV and have not been taking them for 4 days. What implications would that have on my baby. Does defaulting for 4 days pose a higher risk to the baby. I would also like to know if I can breast feed.
Please reply to my email.
Hi Siza,
The test that you were shown yesterday, did it look anything like this:
http://i-base.info/guides/testing/how-long-do-results-take-and-how-are-they-reported
If you think you may not be positive, then you should have another test. However, if you are positive you will need to begin medication straight away. This is because you’re pregnant.
Did they do any other tests that you know of?
If you would like to email me, please do. lisa.thorley@i-base.org.uk
Hi, I’m 34 years old and 3 months pregnant.Yesterday I went for my pregnancy first check up and did all the tests. The HIV one showed one faded line and the other line was clear. I was then told that I’m HIV positive and need to start taking treatment immediately. Is it wise I get a second test done by laboratories before I start taking ARVs?
Hi Magdeline.
Congratulations on your pregnancy.
Delivery options are discussed here in our HIV and Pregnancy guide:
http://i-base.info/guides/pregnancy
If you’re in a resource limited country and on treatment then the World Health Organisation recommend that you can breastfeed for up to 12 months. You do though need to be on treatment. For more info please see here:
http://www.who.int/maternal_child_adolescent/documents/hiv-infant-feeding-2016/en/
I’m HIV positive since 1998,on ARV and I’m three months pregnant. I wanted to ask if it will be possible for me to breastfeed my baby and for how long. Actually I need some advice about breastfeeding and also how to deliver the baby.
Hi Ify,
Being HIV positive shouldn’t be a barrier to having children. Many HIV positive women do have children, and their children are born healthy and negative. Our HIV and pregnancy guide is full of useful information:
http://i-base.info/guides/pregnancy
What’s important is that you’re on medication. It is medication that help reduce the risk of transmission.
Am hiv positive and I want to get pregnant
Hi Ntokozo,
Thanks for sharing some of your story and your wise words.
Good luck with the rest of your pregnancy.
Hi to all the HIV POSITIve pregnant woman
Congratulations to all of you . I was pregnant my first born when I found out I am HIV Positive . I was 3 months when I began attending the clinic and as soon as I found out I immediately began with my ARV’s specifically to protect my Child . Just a piece of Advice ladies when you find out you are HIV Positive especially during your pregnancy you must just stay POSITIVe in mind . the most important thing at the moment is the life you are carrying . To be honest I did not even stress or went through any councelling . MAybe it also because I have lived with HIV positive people and have seen that they are just normal .I have realized that 80% of the people are HIV positive my stat might not be accurate but it just an estimation . It just that some people are not out about it or are just tooo GOOD in understanding that life goes on .Being HIV does not mean you will DIE :). You can be HIV positive but die from a car accident . A negetive person can have kidney failure and die before you while you are HIV Positive .Not everyone with HIV will die from a virus . God has a plan for our lives . The problem begin when you start looking at yourself differently . After birth my sonwent through a number of test and was tested Crystal NEGETIVE !:). I might be HIV positive but I have a negative LIFE that came out of me and that for me is the most AMAZING Thing EVER!. I am a survivor and has managed to protect my son. I am now few weeks pregnant my second baby and I look forward to the experience . Oh well not the experience of giving birth especially since I go vaginal … ;) the natural way … BUT I look forward to protecting my next Angel and deliver him or her safe to this world !