Pregnancy is, on its own, a delicate and difficult process. Imagine going through this process with HIV. How would you handle it? How would you protect your baby from the virus? Through modern medical advances, prevention of the spread of HIV to the unborn child is now possible. But you must follow through with the proper treatments and make the commitment to yourself and your baby.

Latanya Peters was diagnosed as HIV-positive the same day she was told by doctors that she was pregnant. “It’s crazy, just a week before my sister and I were having a conversation about HIV, and I didn’t think for a second that I would have it,” says Peters.

The diagnosis was devastating.

“It took me a while to deal with it, and then I made the decision that I wanted to have the baby and I wanted to do everything that I could do to have a healthy baby,” she says.

The new math on HIV

According to the Centers for Disease Control and Prevention (CDC), since the beginning of the AIDS epidemic in the United States, an estimated 8,779 children who got HIV from their mothers developed AIDS. Nearly 5,000 of these children have died. Fortunately, new AIDS cases in children have steadily declined — from 945 in 1992 to 48 in 2004.

Like their mothers, children born with HIV (Human Immunodeficiency Virus) are also benefiting from early diagnosis and better treatment. Many are living longer and healthier lives due to these life-saving drugs and other preventive measures.

Between 120,000 to 160,000 women in the U.S. are infected with HIV, the virus that causes AIDS. Nearly one out of four of these women don’t know they have the HIV infection. This puts them at higher risk of passing the virus to their babies.

One in 90 Houstonians have been diagnosed as infected with the virus — a shocking number.

Understanding HIV and AIDS

AIDS stands for Acquired Immune Deficiency Syndrome.

A positive HIV test does not mean that a person has AIDS. A diagnosis of AIDS is made by a health care practitioner based on the CDC AIDS Case Definition. Over time, infection with HIV can weaken the immune system to the point that the body has difficulty fighting off certain infections. These types of infections are known as “opportunistic” infections.

Many of the infections that cause problems or that can be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS has weakened to the point that medical intervention may be necessary to prevent or treat a serious illness.

Treatment during pregnancy

The most promising form of treatment available today is anti-retroviral medication. Because of the complexity of selecting and following a regimen and the severity of the side effects, doctors encourage their patients to be involved in the process of selecting a drug that is right for them.

Peters was put on anti-retroviral medication two months into her pregnancy. Patients are usually treated with three medications. The combination of three drugs medicines is called Highly Active Antiretroviral Therapy (HAART).

It was not an easy process for Peters, because she had to make a consistent and conscious effort to maintain her medications. Most prescriptions are available as a twice-daily dosage, and skipping even one dose could put the unborn baby at risk for contracting HIV.

“It’s not like other medications. If you have high blood pressure and forget to take your medication for a day there are minimal repercussions,” says Robin Hardwicke, Ph.D., assistant professor of internal medicine at The University of Texas Medical School at Houston. “Unlike any other medications, if you miss one day of HIV treatments the virus will readily develop mutations that cause resistance, so it is imperative that the patient constantly adhere to taking their medicine.”

Hardwicke treated Peters throughout her pregnancy and understands how taxing the process can be for the individual. To add to the complications, Peters gave birth prematurely during the seventh month of her pregnancy.

“All of a sudden I got this horrible stomach ache. Miinutes later I was giving birth to my baby in my bedroom all by myself,” Peters says. “My dad had just gotten home and my brother was asleep on the couch. They heard me crying and called the paramedics.”

Born at home, Zacharaias Ishmel Peters, two-months premature, weighed in at 4 pounds.

“By the grace of God, nothing was wrong with him. No developmental issues and no HIV,” adds Peters. “He is my miracle.”

Peters is grateful to those who treat her and “Zach.” She also is proud of herself for her conscientiousness with the medications. She still remembers to take her pills every day.

How to prevent transmission

Gloria Heresi, M.D., associate professor of pediatric infectious diseases at the UT Medical School, treats Zach.

Without treatment, 28 percent of women will transmit the virus to their babies. Thanks to the development of the anti-retroviral medications, the rate of transmission is significantly reduced.

“If the mother is treated for HIV during pregnancy with HAART, receives intravenous medications at delivery and the baby is treated for six weeks, then there is a less than 2 percent rate of vertical transmission between mother and child,” Heresi says.

After birth, babies are tested for HIV several times until it is determined whether they carry the virus.

“Another concern is that HIV can be transmitted through breast milk, so breast-feeding is not recommended. Infant formula is the safest alternative to breast milk,” Heresi adds.

Many women feel strongly about breast-feeding their young, which can lead to HIV infection.

Heresi and Hardwicke also treat HIV-positive women who want to discuss family planning. Before they become pregnant, Heresi and Hardwicke encourage women to talk to their health care providers about anti-retroviral treatments during pregnancy and regular blood tests to monitor their “viral load” particularly as the patient approaches her due date.

It’s your right!

“By law, women have the right to prenatal care even if they are uninsured. There is no reason not to take advantage of it. This can make the difference between having an HIV- positive baby or a healthy baby,” Heresi says.

In June 2006, the U.S. Department of Health and Human Services announced that pregnant women will receive prenatal health care under the expansion of its State Children’s Health Insurance Program (SCHIP). Before, the state covered only children from birth to age 19 with family incomes of twice the poverty level.

Advice from experience

Peters, speaking from experience, encourages routine check-ups.

“My advice, you need to get checked out regardless. You may be shocked, but you’d rather be shocked now than find out later on. Be honest with yourself, aside from the finger pointing and however you deal. You need to know, for you! I pray for anyone with this—it’s really a hurt to deal with. It’s easy to think ‘not me,’ but this can happen to anyone. It really can, I am proof,” Peters says.

Last Updated: 2-28-2007

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