I am 28. White. A Female. And a former Peace Corps Volunteer. I am HIV Positive. This is my story of how a few months, a few people, and a few events in Zambia changed me and my life forever. This is the story of how I contracted HIV and brought my Peace Corps Journey to a crashing halt... and how I am working now to pick up and put back together the pieces of my life as a newly diagnosed person living with HIV. This was not the journey I had originally planned... my path has traumatically and dramatically changed... but it is the one I am on now. There is no going back. There is only forward. I welcome you to follow along with me as I attempt to explore this new life ahead of me, whether you are someone from the Peace Corps community, or someone living with HIV. I welcome your comments, questions, suggestions, and opinions. Let us go forward together. To start from the beginning, click here He Gave Me More Than A Bracelet.

Friday, September 20, 2013

If I wanna have a baby...

I am 27 years old. The majority of my friends are getting married and having babies by now...some are even on #3 or 4. I admit that I have a bit of baby fever going on. It is no secret nor anything I'm trying to hide. I really thought I would have had a couple already by this point in my life.

Anyways... on this topic of having babies... I would like to share with you part of a recent e-mail I received. After my (unfulfilling) doctor's appointment a couple months ago, I reached out to a Pediatric HIV Nurse friend to get some better answers about the specific risks and processes involved in a HIV pregnancy. This information comes from a nurse practitioner who follows the children in the clinic who either have HIV or have been exposed to HIV either through childbirth, sexual assault, needle stick injury or some other potential exposure. She follows all of the babies in a 17 county radius who have been exposed in utero to HIV.

"I have researched for the latest data to give you and I find that according to the CDC as recently as 5/2013, they state that as long as a woman knows of her HIV status either prior to the pregnancy or early on in the pregnancy, receives appropriate health care (especially prenatal care), get their viral loads to undetectable and avoids breastfeeding, the rate of transmission is less than 1%.  From 2007-2009 the rate of babies diagnosed with HIV went from 0.8% to 0.1% in Caucasian women.  The rates for Hispanic and African/American babies is a bit higher.  Some of the reasons given for increasing the risk of transmission were lack of appropriate prenatal care, lack of prenatal HIV testing, lack of prenatal antiretroviral medication,  not performing Cesarean delivery for women with a viral load greater than 1,000 copies per mL and not educating women on the avoidance of breastfeeding.

Given the information that you gave to ******, I feel that your risk would be in that less than 1% of transmitting HIV to your baby.  I have worked with this population for 12 years now and in my experience I have seen 2 babies become positive from maternal transmission.  In one case the mother was absolutely awful with taking her medications and had a very high viral load.  This was all despite aggressive education and concern by numerous different staff members from the OB service, our service and mom's care providers. In the other, I suspect that was the case as well, but I don't have specifics as the child was adopted from the hospital.  I do know that this mother was a drug user and the child had drugs in her system at birth.  Because the biological mother never came to see me, I could never get permission to get her records so I had very little information on her actual medical care and all that I have I have needed to piece together from bits and pieces that I have gotten over the last couple of years, but from what I can tell she probably did not take her medications well, if at all, and I do know she did not seek care until late in her pregnancy.

It is the standard of care for mom's to get ARV's during the pregnancy.  The official recommendation is that the woman should have a regimen that includes Zidovudine in it and I usually recommend that if I am asked, but I have seen many women without Zidovudine and as long as their viral load is low the baby is fine.  It is then standard of care that once a woman goes to the hospital she should get an IV started with Zidovudine running from the time she goes in to deliver, until the baby is born.  If scheduled for a c-section or induced labor, that is factored in and started about 2 hours prior to the section or the start of induction medications.  If the baby decides to take matters into his or her own hands and comes either before the medications can be administered or before the full dose is in, as long as the  mom was undetectable and had good prenatal care and did everything correct, I am never concerned about it.   After the baby is born, he or she should receive zidovudine for the first 6 weeks of life.  That should be started as soon after delivery as possible, but most definitely within 6-8 hours of birth.  If the mom's viral load is high or if we do not  have that information because mom was a late care seeker, etc, we also give another medication called Nevirapine.  That is given 3 times within the first week of life and shown to help to prevent transmission when there is a high viral load.  It has not been shown to be any more effective in babies born to mothers who have undetectable viral loads so we do not give it as an added precaution in babies who do not have that added risk.

The site that I accessed the information from was http://www.cdc.gov/hiv/risk/gender/pregnantwomen/facts/index.html if you are interested in reviewing the information yourself."

I am so thankful for this updated information and statistics. I hope you find them as enlightening and encouraging as I do!


  1. I worked in a fertility clinic during my gynae rotation where we helped couples where one or both had HIV to have healthy babies. It's incredible how much can be done to prevent transmission - starting with things such as sperm-washing techniques.
    It is wonderful - if you want to have a baby, you CAN, without feeling guilty. I'm so glad you have someone who can give you up-to-date info like that nurse.
    Keep well!

  2. I am negative and my hubby is poz. We have had two healthy HIV-free children, the natural way. We consulted with a midwife that has a ton of experience in this area. We showed her my hubbys last undetectable result, and she basically told us to go have fun. We have been together 5 years, married for 4. You absolutely can live a normal life. And a happy one too.....I am living proof!

  3. I'm glad that you can have babies without much difficulty.
    They'll be beautiful like you!

  4. I'm so glad you were given this information about trying to have a baby. I am actually working at the CDC about perinatal HIV transmission broadly, though I'm not a doctor so I can't advise you. I would advise you to see an OB/GYN with experience working with HIV+ women. Of course the risk of perinatal transmission in the US not zero but actually quite low.