Question
I'm 6 weeks pregnant, when should I start taking ARVs?
8 May 2012. Related: All topics, Pregnancy, South Africa, Starting treatment.
I have just found out that I am 6 weeks pregnant. I’ve been living with HIV for 7 years.
I want to know when is the recommended time to take medication i.e ARVs and, is breastfeeding safe for the baby and how?
Answer
Firstly, congratulations on your pregnancy.
In response to your first question, the WHO (World Health Organisation) guidelines for the management of HIV in pregnancy, recommend treatment for all pregnant women living with HIV. They also recommend starting ARVs (antiretroviral treatment for HIV) for the prevention of vertical transmission (also known as prevention of mother to child transmission), even if you do not need treatment for your own health.
Having an undetectable viral load by the time of delivery is the only proven way of preventing transmission to the baby. Viral load refers to the amount of virus in your body. An undetectable viral load means there is very little virus present therefore less chance of passing HIV onto the baby.
Therefore, the earlier you achieve and maintain an undetectable viral load, the better.
For more information treatment during pregnancy, please follow this link to our guide to HIV pregnancy and women’s health. The guide also answers a lot of general questions you may have around HIV and pregnancy.
In response to your second question, the safest method of feeding your baby depends on where you live. This is because different countries have different guidelines regarding which methods positive mothers should use.
Here in the UK, the BHIVA guidelines recommend bottle-feeding. This is because, in the UK and most western countries where mothers can have access to formula milk, clean water and bottle sterilising equipment, the risk of transmitting HIV through bottle feeding is zero. However, the guidelines also recognize that the risk of transmission is dramatically reduced if a mother has and maintains an undetectable viral load through out the breastfeeding period.
In some countries (including South Africa) where mothers do not have easy access to the above facilities, the WHO (World Health Organisation) guidelines recommend that, if a woman is taking ARVs, then she should breastfeed exclusively for 6 months. Taking ARVs and having an undetectable viral load dramatically reduces the risk of transmission. Exclusive breastfeeding is recommended because studies have shown that mixed feeding can increase the risk of transmission. After 6 months the baby can then be weaned onto a safe diet without breastfeeding.
As you are based in South Africa, you may also find it helpful to read TAC’s guide to Pregnancy in our lives. TAC (Treatment Action Campaign) are based in South Africa. They support people living with HIV and will be able to put you in contact with other pregnant positive mothers-to-be.
Good luck for the rest of your pregnancy.
Congratulations on the news of your second baby. How is your partner doing? Is she using HIV treatment now?
If your partner is using treatment and her viral load is “undetectable” this will reduce the risk to you if you don;t use a condom. But there may still be a risk and your partner is likely to still be worrying about this.
So this may not be the best time to make your partner stressed over something that may be better to talk about after your baby is born.
It is exciting that HIV treatment can reduce the risk of HIV transmission – but both partners have to feel comfortable enough to agree to this. If your partner wants you to use condoms then it is important to respect this.
This is something to talk about when your partner see’s her HIV doctor.
hi, I am a male with an HIV positive partner who found out when she was pregnant with our first baby. Now she’s pregnant with our second baby. She’s 6 months now. I always test negative.
When we have sex she always wants me two use a condom. What is wrong if i don’t use a condom?