HIV Transmission to the Baby: What Are the Chances and How to Prevent It

The main concerns of people living with HIV are how to have children without passing the infection to them and how to reduce the risk of pregnancy for the mother. Although there is no definite treatment for HIV, there are some medications that can control the virus in the mother’s body and reduce the risk of transmission to the baby. In this article by Raadina Health, we explained how to have a safe pregnancy, what medications are necessary to prevent HIV transmission to the baby, and whether the drugs affect the fetus or not.

HIV Transmission from Mother to Baby: How Does It Happen?

In women with HIV, the mother-to-child transmission happens in three main ways:

1. Through the placenta: The virus infects some placental cells, such as trophoblast cells, and then enters the baby’s bloodstream.
2. Through the amniotic fluid (less common): The virus in the amniotic fluid passes to the fetus when it comes into contact with the fetal membranes.
3. Through genes: Some genes, like CCR5 receptors, change in the mother and fetus. This can increase the chance of HIV transmission from mother to child.

What Are the Chances of HIV Transmission to the Baby?

The risk of HIV transmission during pregnancy and delivery ranges between 15% and 30%. If the mother breastfeeds, this number reaches %45. Note that these numbers are for mothers who don’t undergo antiviral therapy. If they get this treatment, the risk of transmitting the infection during pregnancy will be less than 1%.

Factors Increasing the Risk of HIV Transmission

The most important factors that increase the risk of HIV transmission during pregnancy include:

• High HIV viral load in the mother’s blood.
• Low CD4 cell count, which shows that the immune system is weak.
• Not using antiretroviral medication or delaying treatment.
• The mother has other types of infection, such as tuberculosis or infection of the fetal membranes.
• Choosing vaginal delivery instead of C-section, even when the risk of transmission is high.
• Breastfeeding when the mother has HIV
• The baby has certain biological or physical conditions, like fetal growth restriction (FGR).

HIV Transmission during Delivery

If the mother chooses vaginal delivery but refuses antiviral treatments, the risk of HIV transmission is almost %70 to %75. This happens because the baby comes into direct contact with the mother’s blood and vaginal mucus during birth. The virus can enter the baby’s body through the mucous membranes or small wounds on the skin.

How to Prevent Transmission When the Mother Has HIV

There is no guarantee to prevent HIV transmission from mother to baby. However, the following factors can greatly reduce its risk:

• Taking tests and detecting HIV during pregnancy or even before trying to conceive.
• Starting antiretroviral therapy as soon as possible.
• Using preventive treatments for the baby right after birth
• Choosing the safest feeding type (like formula) to prevent HIV transmission via breastfeeding

Can HIV Pass from the Father to the Fetus?

The only (proven) way that the father passes HIV to his child is when the mother becomes infected through sex with him. Although HIV RNA is sometimes found in sperm, it usually cannot merge with human genes, grow inside the egg, or affect the fetus’s DNA.

Fertilization happens when the sperm and male DNA (genetic material) enter the woman’s egg. HIV needs special immune cells to multiply, and these cells are not present when egg and sperm are mixing. That’s why transmission of HIV from father to fetus is very complex and rarely happens.

Do Medications Prevent HIV Transmission to the Baby?

Taking antiretroviral medicines from the start of pregnancy until after delivery can reduce the risk of passing HIV to the baby by %30 to %60. For example, doctors prescribe only Zidovudine (ZDV) or combine it with Lamivudine (commonly called 3TC) to lower the risk of transmission. Preventive medicines such as Nevirapine can also reduce the risk of transmission.

Is There Any Treatment that Lowers the Risk of HIV Transmission to Zero?

If the mother begins antiretroviral therapy before trying to conceive and continues it through pregnancy and breastfeeding, the risk of passing HIV from mother to child can be reduced to almost zero. In other words, the mother should take medicines until her viral load reaches 50 copies/mL and stay at that level until after delivery.

Real Cases of HIV-Positive Mothers Who Gave Birth to Healthy Children

Nigeria conducted a large study on HIV-positive mothers who received antiretroviral treatment throughout their pregnancy. Out of 996 babies, 838 (up to 18 months of age) were completely healthy without a single sign of HIV in their blood. Similar studies in Rwanda, South Africa, and Bangladesh reported that infection rates in newborns were about %1.58, %2.52, and %5.88, respectively. These findings show that preventive treatments are actually helpful.

Common Myths about HIV Transmission to the Baby

There are many false beliefs about how HIV passes from parents to children. Here are three of them:

• All newborns with HIV-positive parents carry the virus.

One of the most common myths is that babies who have HIV-positive mothers definitely carry the virus. But the statistics show that many women living with HIV can prevent transmission to their babies by undergoing medical treatment.

• Vaginal delivery always causes HIV transmission.

Another wrong belief is that babies born through vaginal delivery definitely get HIV. If the mother’s viral load is controlled, vaginal delivery can be as safe as a C-section. In fact, some doctors prefer vaginal delivery, even when a C-section is possible.

• Physical contact leads to infection.

Some people believe that when the infected mother touches the baby or feeds them with formula, she is infecting her child. This is absolutely wrong! Normal physical contact or feeding the baby with formula does not spread the virus. Such social fear comes from a lack of knowledge about how the infection is actually transmitted.

The Last Notes

If you are worried about transmitting the infection to your children, your feelings are totally normal and understandable. However, if you don’t update your information about how this virus is passed, you will miss your chance to become parents or be fully treated.

Get a free consultation, precise treatment planning, dedicated support, and a personalized medical travel roadmap. Contact the experts at Raadina medical tourism company today.

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FAQs

1) If only the father has HIV, will the baby become infected?

No. It is very unlikely that HIV passes from father to fetus. In other words, you can have healthy children if the mother is not infected.

2) Does having sex during pregnancy increase the risk of HIV transmission?

Yes. Although it’s rare, if the mother becomes infected with HIV during pregnancy, the baby may also get it.

3) Will the baby get HIV at birth?

Not necessarily. Choosing a safe delivery method, undergoing preventive treatments, and feeding the baby with formula can reduce the risk of HIV transmission.

4) In which month of pregnancy is the risk of HIV transmission higher?

The risk of transmitting the virus is lower in the early months of pregnancy, but it increases in the third trimester. That’s why the doctors recommend starting the medication therapy as soon as possible, and continuing it until delivery.

5) Does the type of delivery affect HIV transmission?

Yes. A C-section is usually safer than vaginal delivery, but there is no guarantee that the baby will not get the infection during the operation. Also, vaginal delivery does not always lead to transmission. Therefore, it’s better to trust your doctor in choosing the best delivery method.