HIV infection is caused by the Human Immunodeficiency Virus. This virus can cripple the body's immune system, leaving a person vulnerable to numerous diseases, including certain infections and cancers.
AIDS, or Acquired Immunodeficiency Syndrome, is the most advanced stage of HIV infection. This occurs in many, but certainly not all, patients infected with HIV. Many people are now living much longer with the use of anti-viral, anti-HIV medication.
It is estimated that over 1 million people in the United States are living with HIV/AIDS, and another 500,000 Americans have died of the disease since it was discovered in 1981. Over 25 million people worldwide have died of HIV/AIDS, many of these people in developing countries.
The Centers for disease control (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommend that ALL pregnant women undergo HIV screening as standard medical practice.
The reasons for this are straightforward:
- HIV may be passed on to an infant through the placenta, at the time of delivery, or through breast milk
- An untreated HIV-positive woman has a 25 - 33% risk of passing on her HIV infection to her child
- A woman known to be HIV-positive and who receives anti-viral medications, delivers by cesarean section, and doesn't breastfeed has only a 1 - 2% risk of passing the infection to her child
A mother who knows that she has HIV and takes appropriate measures will minimize the risk that her child will be infected with HIV.
HIV testing is done on a small sample of your blood. This is usually obtained when blood is taken for your other routine prenatal blood tests.
Please ask your obstetrics provider if you have questions about HIV testing.
Specific Risk Factors for HIV Infection
There are certain situations that place women at high risk for infection; for example, if they have:
- Shown clinical evidence of HIV/AIDS infection, such as severe weight loss, loss of appetite or energy, enlarged lymph nodes, unexplained frequent fevers or sweats, white spots in the mouth or purple lesions on the skin; however, it's important to know that early HIV infections have no symptoms
- Used intravenous (IV) drugs for non-medical purposes
- Emigrated from countries in the Caribbean and Africa where heterosexual transmission is thought to play a major role in the spread of the disease
- Engaged in prostitution or had multiple sexual partners
- Received transfusions of blood or blood products between 1978 and 1985
- Had a sexually-transmitted disease such as chlamydia, gonorrhea, syphilis or genital herpes
- A positive TB skin test
- Had sexual contact with a person with hemophilia or who has used IV drugs
- Had sexual contact with an HIV-positive partner or with a partner whose HIV status is unknown
Wisconsin has a relatively low incidence of HIV infection when compared to other states or regions of the United States.
If you have moved to this area from another state, or had a prolonged stay in certain countries in the Caribbean or Africa, the incidence of HIV/AIDS in your former location may be a risk factor.
In considering the risk of HIV/AIDS resulting from a blood transfusion, the timing of the transfusion is very important. A high-risk time for receiving a blood transfusion was between 1978 and 1985, but since the mid-1990s blood transfusions have become much safer. There is now one chance in approximately two million of getting HIV/AIDS infection from transfusion of a unit of blood.
If you're planning or contemplating a pregnancy with a man who is at increased risk for HIV/AIDS infection, he should also be counseled and tested.
Can I Still Be Tested?
If you declined testing at your first prenatal visit, but have since decided to be tested, there is no need to schedule a special appointment. The testing can conveniently be performed during your next regularly scheduled visit with your obstetric provider.
Wisconsin law requires that a patient give her verbal consent before having an HIV test performed.