Of all the cases of aids, the acquired immune deficiency syndrome, more than 10% occur in women.  Hiv, the human immunodeficiency virus, causes aids.  Aids is a leading cause of death in women of childbearing age.  A woman who is infected with hiv can pass the infection to her unborn child.  In the united states, this happens 25-30% of the time.  Many women have been diagnosed with aids after delivering an aids infected infant.

How does a mother transmit the infection to her baby?  It may happen during the pregnancy, while the baby is in the womb.  The mother may have a viremia.  That is, an increase and spread of the hiv virus in her body.  That could spread the infection to the baby.

Some babies are infected by the mother's blood or vaginal secretions as they pass through the birth canal.  This was detected through twin studies.  The first born twin was more likely to get aids in this way.  In very rare cases, babies may get aids from breast milk from an infected mother.

Pregnant women with aids, especially those who use illicit intravenous drugs, are more prone to infections during pregnancy and just after delivery than women who are not hiv positive.  Some infections, called opportunistic infections, are caused by bacteria and fungi that usually don't infect healthy people.  Among these are pneumocyctis carinii pneumonia--also called pcp, and tuberculosis. Other opportunistic infections can cause a serious illness in a baby even if the baby doesn't get aids from its' mother.  Among these are cmv (cytomegalovirus), and toxoplasmosis. Many of the drugs used to treat aids and the infections associated with aids could be harmful to unborn babies. 

Physicians treating pregnant women who are hiv positive must decide if the benefit of using the drug on the mother outweighs the risk of harm to the baby.  It can be a very difficult choice. If a pregnant woman is positive for hiv, she may also need treatment for other sexually transmitted diseases.  These can i

nclude syphilis, gonorrhea, herpes and chlamydia.  These diseases can also cause problems for the baby.

When a physician knows that a pregnant woman has a positive hiv test, or, if she has been diagnosed with aids, he asks to have special tests done on the baby soon after it is born.  The baby will have a skin test for tb.  It will be tested for sexually transmitted diseases, toxoplasmosis and cmv. The baby may also be given treatment to avoid pneumocyctis carinii pneumonia.  If the baby's cd-4 cells are low, it may be treated with a drug to hopefully prevent aids.

A woman who has aids and becomes pregnant would have a 1 in 4 chance of infecting her baby.  Even if the baby didn't get aids, it could get seriously ill and maybe even die from infections that its' mother had during pregnancy.

A woman with a positive hiv test should think carefully about becoming pregnant.  Even if the baby were born healthy, how well could the mother cope with the realities of providing physical, emotional and financial support for her child while she was sick and dying herself?  Who would take care of the baby when she no longer could?

The woman with a positive hiv test must think seriously about birth control.  In addition to using a latex condom, she can contact her physician or the county health department to learn more about birth control.

Aids is a fatal disease.  To keep from getting aids, a woman should remember that the best sexual relationship is monogamous and began before the aids virus was discovered.  Relationships between partners where both have been hiv negative for six months and neither has engaged in high-risk sexual activities are also considered safe.  Some ways to avoid high-risk sexual activities are to:
1.  Use latex condoms.
2.  Avoid sex during menstruation.
3.  Have regular medical check-ups.
4.  Avoid using illicit intravenous drugs.
5.  Avoid using alcohol and drugs before sexual activity since they can alter your judgment so that unsafe sexual practices are easier to fall into.

If a woman who is hiv positive or has aids suspects that she is pregnant, she should see her physician without delay.