HIV and Perinatal Transmission: Prevention Challenges

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Some pregnant people with HIV may not know they have the virus. CDC recommends HIV testing as part of routine prenatal care. According to CDC research, more people take the prenatal HIV test if the opt-out approach is used. Opt-out prenatal HIV testing means that pregnant people are told they will be given an HIV test as part of routine prenatal care unless they opt out—that is, choose not to have the test. In some parts of the country where HIV is more common, CDC recommends a second test during the third trimester of pregnancy.

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People with HIV may not know they are pregnant, how to prevent or safely plan a pregnancy, or what they can do to keep their baby from getting HIV.

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To get the full protective benefit of treatment, the pregnant person needs to take HIV treatment as prescribed—without interruption—throughout pregnancy and childbirth and provide HIV medicines to the infant in the first weeks of life. The pregnant person with HIV may have nausea that can interfere with HIV treatment, or they may not be able to see their HIV medical care provider consistently.

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Social and economic factors, especially poverty, create barriers to health care that disproportionately affect people with HIV. Pregnant people may face more barriers to accessing health care and staying on treatment if they also inject drugs, use other substances, are experiencing homelessness, or are incarcerated, mentally ill, or uninsured.

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