Each day about 1800 children worldwide become infected with HIV (human immunodeficiency virus), the majority of them newborns. Most newborns and children with HIV became infected through pregnancy, the birth process, or breast milk from HIV-infected mothers (mother-to-child transmission). Although there is no cure for HIV or AIDS (acquired immunodeficiency syndrome), treatment is available to prolong life and to prevent transmission of the virus from a mother to her baby. The July 19, 2006, issue of JAMA includes an article about how treatment of HIV in children in the United States has led to a decline in HIV-associated infections.
Take measures to protect yourself from contracting HIV. HIV is spread through unprotected sex with an infected partner, through infected blood, and through contaminated needles.
Maintain good health during pregnancy. Avoid tobacco, alcohol and illicit drugs, and risky sexual behaviors while pregnant. Get proper nutrition and seek regular prenatal care.
Get tested for HIV, especially since many people infected with HIV have no symptoms. It is recommended that all pregnant women be tested for HIV. Your doctor can counsel you about HIV testing. Many sites offer anonymous testing.
There are several precautions a pregnant woman infected with HIV can take to prevent the spread of HIV to her baby, reducing the risk to a low level. Treatment of HIV infection with antiretroviral drugs (medications that help fight HIV) during pregnancy and labor can help lower the risk of transmission. Preventive treatment for the newborn can also help reduce the risk of transmitting the virus. Taking HIV medications properly is necessary to prevent the virus from becoming resistant (more difficult to treat). Some antiretroviral drugs are not recommended for use during pregnancy. Discuss the proper treatment regimen and monitoring with your doctor.
Having a cesarean section birth may reduce the chance of transmitting the virus in some women. There are risks associated with cesarean section. Discuss with your doctor whether a scheduled cesarean section or vaginal delivery would be best for you.
In the United States, women infected with HIV should use formula and should not breastfeed in order to prevent transmission of the virus to the baby through breast milk.
Babies are tested for HIV differently than adults. Discuss how best to test for HIV in babies with your doctor.
It is recommended that babies born to HIV-infected mothers receive an antiretroviral drug such as zidovudine after birth. They should also receive medication to prevent HIV-associated infections. Discuss the recommended drugs and follow-up with your doctor.
US Department of Health and Human Serviceshttp://www.aidsinfo.nih.gov
National Institute of Allergy and Infectious Diseaseshttp://www.niaid.nih.gov
Centers for Disease Control and Preventionhttp://www.cdc.gov/hiv/
World Health Organizationhttp://www.who.int/hiv/en
Joint United Nations Programme on HIV/AIDShttp://www.unaids.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on HIV was published in the July 14, 2004, issue.
Sources: US Department of Health and Human Services, National Institutes of Health, Centers for Disease Control and Prevention, World Health Organization, Joint United Nations Programme on HIV/AIDS
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
Brender E, Lynm C, Glass RM. Preventing HIV Infection in Infants and Children. JAMA. 2006;296(3):356. doi:10.1001/jama.296.3.356