HIV in pregnant women: causes, risks, how to treat, and prevent

Referring to the circular letter of the Directorate General of Disease Prevention and Control (P2P), from the beginning of 2017 to June 2019 there were 11,958 pregnant women in Indonesia who tested positive for HIV after undergoing a test. HIV and AIDS in pregnant women is not a small issue that can be ignored. This is because pregnant women who are HIV-positive have a great chance of transmitting them to their babies since they are still in the womb. So, what causes HIV transmission to pregnant women and what are the risks for their future babies? More below.

Causes of HIV and AIDS in pregnant women

HIV is an infectious disease caused by human immunodeficiency virus. This virus attacks T cells (CD4 cells) in the immune system whose main task is to fight infection.

The virus that causes HIV is spread from one person to another through the exchange of body fluids such as blood, semen, pre-ejaculatory fluids and vaginal fluids which are very common during sexual intercourse.

So based on the 2017 Ministry of Health report, there is an increasing trend in the number of new HIV cases among housewives. As quoted from The Jakarta Post, Emi Yuliana from the AIDS Prevention Commission in Surabaya said the number of housewives with HIV / AIDS was higher than that of female commercial sex workers.

The magnitude of this figure is likely influenced by the routine sex with an HIV positive husband (whether diagnosed or known, or not). Penile-to-vaginal penetration without a condom is the most common route of HIV transmission among heterosexual couples (men who have sex with women).

After entering the body, the virus can remain actively infecting but not showing significant symptoms of HIV / AIDS for at least 10-15 years. During this window period, a housewife may never know that she has HIV until she ends up being pregnant.

Apart from sex, a woman can also become infected with HIV from using non-sterile needles before becoming pregnant.

The dangers of HIV infection in pregnant women and babies

A weak or damaged immune system due to chronic HIV infection can make pregnant women very vulnerable to opportunistic infections, such as pneumonia, toxoplasmosis, tuberculosis (TB), venereal disease, and cancer.

This collection of diseases indicates that HIV has developed into AIDS (Acquired Immune Deficiency Syndrome). People with HIV who already have AIDS can usually live for about 3 years if they don't get treatment.

Without proper medical treatment, each of these infections also carries the risk of causing its own complications on the health of the body and pregnancy. Take toxoplasmosis, for example. Parasites that cause this disease can infect babies through the placenta, causing miscarriage, stillbirth (stillbirth), and other adverse effects for mother and baby.

The dangers of HIV for pregnant women and their babies are not only that. Pregnant women who are diagnosed with HIV can also transmit the infection to the unborn baby through the placenta. Without treatment, a pregnant woman who is HIV positive has a 25-30% risk of transmitting the virus to her child during pregnancy.

HIV transmission from pregnant women to their children can also occur during normal delivery, if the baby is exposed to blood, broken amniotic fluid, vaginal fluids, or other body fluids from the mother. In addition, HIV transmission from mother to baby can also take place during the exclusive breastfeeding period because HIV can be transmitted through breast milk.

HIV from mothers can also be transmitted to their babies through food that the mother chews first, although the risk is very low.

HIV testing in pregnant women

If you contracted HIV while pregnant or have had it since before pregnancy, consult your doctor. Your doctor will advise you to get tested for HIV as soon as possible; Go straight to the first check-in schedule if possible. A follow-up HIV test will also be recommended by your doctor in the third trimester of pregnancy and after the birth of your baby.

The most common HIV test in pregnant women is the HIV antibody test. The HIV antibody test looks for HIV antibodies in a blood sample. HIV antibodies are a type of protein that the body produces in response to viral infections.

HIV in pregnant women can only be completely confirmed when they get a positive result from an HIV antibody test. The second test is an HIV confirmatory test to confirm that the person is indeed infected with HIV. If the second test is also positive, it means that you were positive for HIV during pregnancy.

HIV testing in pregnant women can also identify the presence of other sexually transmitted diseases, such as hepatitis C and syphilis. In addition, your partner should also be tested for HIV.

HIV treatment in pregnant women

A mother who finds out she was infected with HIV early in her pregnancy has more time to start planning treatment to protect the health of herself, her partner, and her baby.

HIV treatment is generally carried out through antiretroviral drug therapy (ART). This combination of drugs can control or even decrease the amount viral load HIV in the blood of pregnant women. Over time, routinely undergoing HIV treatment can increase the body's resistance to fighting infection.

Adherence to ART therapy also allows pregnant women to prevent transmission of HIV infection to their babies and partners. Several anti-HIV drugs have been reported to be passed from pregnant women to unborn babies through the placenta (also called the placenta). The anti-HIV drugs in the baby's body help protect him from HIV infection.

Prevent HIV transmission from pregnant women to children

Fortunately, pregnant women can reduce the risk of transmission to their babies by implementing the right HIV prevention measures. With proper treatment and planning, the risk of transmitting HIV from pregnant women to babies can be reduced by 2 percent throughout pregnancy, childbirth, childbirth, and breastfeeding.

If you test positive for HIV, there are several things you can do to reduce the risk of passing HIV to your baby.

1. Routinely take medication

If you were diagnosed with HIV during your pregnancy, it is recommended to start treatment immediately and continue daily.

HIV treatment in pregnant women needs to be done as soon as possible after pregnant women are diagnosed with HIV. However, antiretroviral drugs are not only used during pregnancy. To overcome the symptoms of HIV as well as the emergence of HIV complications, HIV treatment in pregnant women needs to be lived for a lifetime.

Treatment is also not only aimed at pregnant women. After birth, the baby will also be given HIV drugs for 4 to 6 weeks to reduce the risk of infection from HIV that may enter the baby's body during the birth process.

2. Protect your baby during labor

If you started routine medication long before pregnancy, it is possible that your viral load is undetectable in your blood. This means that you can plan for a normal vaginal delivery because the risk of passing HIV to the baby during labor is very small.

However, if the doctor sees that you are still at risk of transmitting the virus to your baby, you will be advised to give birth by caesarean section. This procedure carries a lesser risk of transmitting HIV to the infant compared to vaginal delivery.

3. Protect the baby during breastfeeding

Breast milk contains the HIV virus.

In general, doctors will recommend that you breastfeed your baby with formula milk. However, if you want to breastfeed exclusively, you must always remember to continue using the medication for at least 6 months.

If you are unsure whether or not you should breastfeed, talk to a medical professional for further specialist advice.