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 Tebo,
Feeling frustrated is common. As too is shock especially when you’re diagnosed when you’re pregnant. What you need to do is give yourself some time to breath. You must however go back to the clinic as you will need to start medication. Its important that you’re on meds because its the meds that will help reduce the risk of transmission to your baby. For more info, please see here:
http://i-base.info/guides/pregnancy
With regards to how you may have contracted HIV, if you think it was your husband then you could talk to him about it.
Is their someone you can talk to for support?
I am 16wks pregnant and recently diagnosed with hiv. After being tested positive I just walked out of clinic due to the frustration. Now i dont know where to start i havent told my husband about this and its killing me inside since i now know my status. I use to test before and my last before this one was in 2015/4 I tested neg with my ex boyfriend.
Hi Teeky,
If you’re being sick right after taking your meds, you should talk to your doctor about this.
Hi Lisa
I take them at 9 pm, sometimes I vomit right after I took sometimes 2 hrs after or so
Hi Teeky,
What time of the day are you taking your meds? And when you vomit, how soon after is this?
Hi Lisa thank you for getting back to me, 1st I am taking Trivenz, 2nd I wasn’t aware what elite controller is lol though I just googled it, yes it seems I am as I mentioned was diagnosed in 2012 only started arvs last month my doctors even send me to pathcare to take elizer test as he thought mybe I was not positive due to my viral load and I had never taken arvs begore. Lastly yes I do believe vomitting is due to my pregnancy however my most concern is I vomit even after taking meds therefore I worry that they will not work.
Hi Teekay,
What meds are you on? What time are you taking them? The feeling tiered and vomiting could be due to your pregnancy and not the meds.
Are you an elite controller?
Hi I’m 14 weeks pregnant nd been HIV since 2012 and just started treatment 3 weeks ago my cd4 was 1120 viral load undectatable I insisted I wanna start treatment as I was scared since I’m pregnant but now I feel like I could have waited as I’m not coping I vomit everyday sometime even after taking my meds so I don’t even know if the treatment will work or not I am drained due to vomiting and tiredness, please help me I havnt been to my doctor to advise him about this planning to see him soon though
Hi Ayakhe,
How long are you going to be away from home for? What meds are you taking? If you could let me know, I’ll be able to help you.
Also, do you know what your viral load is? I’m asking because when a woman is pregnant, its the viral load that’s important.
I’m 28 weeks pregnant and taking ARV’s. The Problem is, I’m away from home and my meds have ran out. Will this be a problem?