HIV & PregnancyHIV & Pregnancy
In Canada, the opportunity for HIV counseling and testing during pregnancy is part of a strategy to reduce the number of babies born with HIV and to offer treatment options to women as soon as possible. Testing policies are different in each province. Regardless of where you live in Canada, however, it is your choice whether or not to be tested for HIV during your pregnancy.
- Before deciding to take an HIV test you should always be offered the opportunity to talk to someone about the test and what the result will mean (“pre-test counseling”).
- When you get the results of your HIV test, you should be given the opportunity to talk to someone about the results – whether they are positive or negative (“post-test counseling”).
In Canada there are two approaches to pre-natal HIV testing:
- Some provinces offer voluntary HIV tests (called the opt-in approach) which includes pre- and post-counseling to all pregnant women as part of prenatal testing. You have the choice of declining opt-in HIV testing.
For more information about the practices in your province or territory, consult the annual HIV/AIDS Epidemiology (Epi) Update created by the Public Health Agency of Canada.
If you would like more information you can contact your health care provider, local Canadian Federation for Sexual Health (CFSH) member, Planned Parenthood or Sexual Health Centre.
Testing positive while you are pregnant
Testing positive while you’re pregnant can be overwhelming – you may be thinking about how the results could affect your own health as well as what it means for your pregnancy. Choosing a pregnancy option is a personal decision. In Canada, you have the right to choose the pregnancy option that feels right for you.
You can choose to:
- Continue your pregnancy and take treatment to reduce the risk of your baby acquiring HIV
- Continue your pregnancy without treatment
- Have an abortion (end the pregnancy)
Being HIV positive and having a baby
Many HIV positive women give birth to healthy babies who are HIV negative. However, there is a chance your baby could be HIV positive. Here are some things to consider:
- Being pregnant will NOT speed up the rate at which HIV progresses in your body (your health will be same as before getting pregnant)
- Without any drug treatments, it is estimated that in Canada 15-30% of women with HIV infection will transmit the infection during pregnancy and delivery, and 10-20% will transmit the infection through breast milk to their new-born child¹.
- In 2005, 4% of women taking specially designed drug treatment (antiretroviral drugs), transmitted HIV to their babies¹.
- Invasive medical procedures such as amniocentesis, chorionic villus sampling (CVS), foetal scalp sampling, cordocentisis, internal fetal monitoring during labour and umbilical cord sampling increase the risk of passing HIV to your baby
- Ultrasound does not affect HIV transmission
Preventing maternal-infant transmission of HIV
While treatment options vary from woman to woman, here are 4 strategies that can help reduce the risk of transmitting HIV to your child:
- Prenatal care: As soon as you discover you’re pregnant, visit your health care provider. Your health care provider can inform you on how to maintain a healthy pregnancy.
- Anti-HIV strategy: This may include using anti-retroviral or immune therapy to reduce the level of HIV in your blood. This decreases the chances of transmitting HIV to your baby. The plan also includes treating other conditions or opportunistic infections like pneumonia or sexually transmitted infections (STIs) if you have them.
- A plan for delivery of the baby: Good obstetrical practices to prevent premature birth, rupture of membranes and the unnecessary use of instruments during delivery are thought to reduce the risk of transmission during delivery. Also, certain kinds of caesarean-sections (C-sections) have been linked to decreased transmission rates, since the infant has less exposure to maternal blood and secretions.
- Breast-feeding: Because HIV can be transmitted through breast milk, safer alternatives (bottle-feeding or feeding with milk from human milk banks) can reduce the risk of transmission.
Your baby’s HIV status
You may want to know right away if your new baby is HIV positive or not; however, it takes at least 3 months and sometimes as long as 18 months to confirm your baby’s HIV status.
The standard HIV test cannot be used before the baby is 18 months old. New born babies have their mother’s antibodies until 18 months. Babies who are HIV positive will start making their own HIV antibodies by the time they are 18 months old and so should test positive at that point.
The Polymerase Chain Reaction (PCR) test is a more sensitive test than the standard test, and it detects the presence of HIV as opposed to the antibodies. It can be used accurately from the time a baby is about 3 months old.
