Busting Myths on HIV and Pregnancy

Every year World AIDS Day is observed on 1^st December to create awareness about the disease. The third Sustainable Development Goal (SDG-3) has a target to end the epidemic of HIV/AIDS by 2030 (Project 2030). This will be achieved when the number of new HIV infections and ‘AIDS-related deaths decline by 90% between 2010 and 2030. By 2025, 95% of all people living with HIV (PLHIV) should have a diagnosis, 95% of those should be taking lifesaving antiretroviral treatment (ART) and 95% of PLHIV on treatment should achieve a suppressed viral load for the benefit of the person’s health and for reducing onward HIV transmission. There has been a significant revolution in the treatment of HIV/AIDS since 1996 till date, innovation in HIV tools such as effective single pill daily (ART) keep the viral load below the target level and effective prevention strategies (pre-exposure or post-exposure) prevent viral transmission including prevention of transmission of the virus from mother to child. Soon long-acting injections are expected in India to further improve adherence.  Affordable viral testing has enabled significant progress in long-term monitoring and follow-up of PLHIV.

However, despite all efforts, stigma and discrimination remain formidable barriers to effective HIV testing, prevention, and care. HIV stigma is rooted in a fear of HIV. PLHIV especially key populations are still struggling to overcome their fear and do not come out to avail treatment.  Here we bust some myths about HIV related to pregnancy and childbirth.

Myth: HIV always leads to AIDS which means death.

Fact: HIV attacks the immune system, while AIDS is a medical condition caused by HIV infection in advanced stages when the immune system is severely weakened. With effective ART pills, it is possible to keep the viral load to a very negligible level and halt the progression of HIV into AIDS.

Myth: HIV-infected people cannot have children safely.

Fact: With effective medications, HIV-infected people can have children safely. Pre-exposure prophylaxis can be offered to couples where one partner is negative so that they may conceive naturally or they may go for assisted reproductive techniques like intrauterine insemination or in vitro fertilization where the chance of HIV transmission becomes negligible.

Myth: Children born to HIV-infected mothers are always at risk for contracting HIV.

Fact: HIV can also be transmitted from a pregnant person to their child during pregnancy, delivery, and through breastfeeding. However, the risk of transmission of HIV from infected mothers to a child is almost negligible if the mother has suppressed viral load while continuously taking medicines. After birth child is also given medicine as a post-exposure prophylaxis.

Myth: Caesarean Section is always required for HIV-infected pregnant females to prevent transmission to a child.

Fact: With modern antiretroviral therapy (ART), the viral load becomes negligible in the mother’s body and the chance of transmission during delivery is reduced significantly, hence pregnant females can go for normal vaginal delivery. Cesarean section is indicated only for obstetric reasons.

Myth: Children born to HIV-infected mothers should not be breastfed.

Fact: HIV-infected mothers should be breastfeeding babies as long as possible along with daily ART medicines to prevent transmission of the virus through mothers’ milk.