Treatment training manual

6. 5 ART during pregnancy: when to treat

  • Most guidelines now recommend ART for all HIV positive people. This includes people with a high CD4 count (above 500 cells/mm3).
  • ART is especially important during pregnancy to reduce the risk of transmission to the baby.
  • Reducing viral load to undetectable dramatically reduces the risk of transmission.
  • Transmission drops from almost 10% in untreated women to less than 1% in women treated with an undetectable viral load on ART.

If a woman is already using ART when she becomes pregnant

Many women decide to have a baby when they are already on ART. A woman conceiving on effective ART should continue to take it.

If a woman is diagnosed during pregnancy

ART is recommended for everyone with HIV. If someone is diagnosed during pregnancy she should start ART.

If a woman discovers she is HIV positive late in pregnancy

If the HIV diagnosis is very late in pregnancy, ART is very important. This might involve a combination of HIV drugs with the biggest early impact on viral load.

Even with only a few days ART, viral load will be dramatically reduced.

Even after 36 weeks, ART will reduce the mother’s viral load to very low levels.

Last updated: 1 January 2016.