ART is recommended for all HIV positive pregnant women, no matter what their viral load is. A once-daily fixed-dose combination of TDF + 3TC (or FTC) + EFV will be given as first-line ART for pregnant and breastfeeding women, and Nevirapine (NVP) will also be given from the start of pregnancy.
Some of the side effects of ART that pregnant women might experience are similar to the symptoms of pregnancy, this makes it hard to know what is causing the side effects .
- Wanting to vomit. This could be morning sickness.
- Diabetes (high blood sugar)
- Anemia (low red blood cells) which makes the pregnant woman feel very tired.
Will being pregnant make my HIV worse?
Being pregnant does not make HIV worse. A pregnant woman's CD4 count may drop a little, but will pick up again once the baby is born. A CD4 count is less important than the viral load test for checking whether treatment is working. Taking ARVs can help to boost your immune system during pregnancy.
Antiretroviral therapy (ART) during labour
If you are already on ART, you must continue with your treatment as usual during labour, but if you are only diagnosed HIV positive when you are in labour, you will be given a dose of Nevirapine, Truvada and AZT every three hours during labour, and then the your doctor or nurse will start you on the fixed dose combination pill (FDC) immediately after giving birth as the start of your lifelong ARV journey. Having a natural birth or a caesarean section does not change the ART given to you during labour.
How will I know if my baby has been infected with HIV?
Babies born to HIV positive mothers will always test positive for HIV if an antibody test is used because the mother's antibodies are passed onto the child. For this reason, a PCR DNA or RNA test that looks for th virus in the baby's blood will be used. This test can be done on the day the baby is born.
Antiretroviral therapy (ART) for new-borns
- Babies of mothers who are on ART and are breastfeeding will be given nevirapine every day for the first six weeks of their life;
- If the mother isn't on ART, and is breast-feeding, the baby will be given nevirapine daily for up to three months;
- If the mother is not breastfeeding, and the baby did not receive nevirapine, the baby will be started on ART.
- Babies who are exposed to HIV will be tested regularly to check their HIV status.
I am an HIV positive mother. Is it safe to breastfeed my baby?
HIV can be passed on through breast milk, but if the mother is virally suppressed there is very little risk of this happening. The benefits of breastfeeding outweigh the risks because:
- Breast milk is more nourishing than formula;
- The antibodies from breast milk protect babies against infections like pneumonia which can be life threatening;
- Breastfeeding is free and formula is expensive;
- Feeding babies only breast milk for the first 6 months if the mother is on ART reduces the risk of passing HIV on to the baby;
- Breastfeeding can be combined with other feeding after 6 months and continued until 12 months.
If you are breastfeeding on ART you will be given a daily dose of NVP for the first 6 weeks your child's life. If you are not on ART, but you are diagnosed as HIV positive when you are in labour, you will be given NVP for the first 6 months of your child's life in order to preventing passing on the HIV infection to your new-borns.
If you cannot or chose not to breastfeed your child and your child is on formula feeds, your child will be given four to six weeks of infant prophylaxis with daily Nevirapine or a twice-daily dose of AZT.