Pregnant and newly diagnosed, do I need to take ARVs?
I am pregnant and I just found out that I have HIV. My CD4 is 754.
Should I take ARVs?
What will happen when if I stop the meds after delivering my baby?
If I terminate this pregnancy will I be at risk?
I’m very sorry to hear about your recent diagnosis.
Finding out you are HIV positive is never easy but finding out while pregnant can be especially hard.
However, it is much better that you found this out now so that you can use ART.
It might also help to know that many women have been through this before. You are not on your own – there are services and care available to help you.
You asked several questions so I will go through each of these one at a time.
Your asked whether you need to take ARVs?
In 2016, most treatment guidelines recommend HIV treatment (ART) for anyone who is HIV positive. This includes during pregnancy.
ART is recommended both for your own health and to prevent transmitting HIV to your baby.
In the UK most pregnant HIV positive women will take three HIV drugs. The choice of drugs will depend on your health and other foctors.
It is generally recommended to continue ART after birth. However, guidelines vary in different countries. Your doctor should be able to tell you what the guidelines are where you live.
You asked what will happen if you stop the meds after delivering your baby.
Your baby should continue to receive treatment for four weeks after birth. If you are breastfeeding you will need to continue to take ART.
Because your CD4 count is so high, if you need to stop treatment at the end of this time, this is also okay. This was the practice for many years.
Guidelines generally now recommend staying on ART though.
You also asked whether you would be at risk if you terminate this pregnancy?
For this I would first ask whether there is a reason why you are considering an abortion, also known as TOP (termination of pregnancy).
Is it because you are worried that the baby may be born positive? If that is the main reason why, then it might be useful for you to know that with access to ART, plus care and support, most women living with HIV have healthy babies that are HIV negative.
It may be, however, that you already have the information above and this is a decision you have chosen to go ahead with for other reasons.
In this case, an abortion should not carry any more risks than it would for an HIV negative woman. This is dependent on the abortion being carried out using the right procedures, in a hospital and with the right treatment and care.
This answer was updated in January 2016 from a question posted on 11 May 2012.