Case 14. “AIDS Is Not My Worst Problem”: Caring for Women with HIV
Download MP3The case of a 28-year-old diagnosed with HIV when she became pregnant prompts Eileen and guest Dr. Jean Anderson to explore many of the challenges of HIV care in pregnancy: managing a new diagnosis, disclosure, stigma, partner involvement, antiretroviral therapy, perinatal transmission prevention, breastfeeding, harm reduction, and postpartum care. Their wide-ranging discussion opens with Jean’s perspective on care of women with HIV, which is informed by 40 years of ground-breaking work in the field.
References Cited:
References Cited:
- Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994 Nov 3;331(18):1173-80. PMID: 7935654.
- Sibiude J, Le Chenadec J, Mandelbrot L, et al. Update of Perinatal Human Immunodeficiency Virus Type 1 Transmission in France: Zero Transmission for 5482 Mothers on Continuous Antiretroviral Therapy From Conception and With Undetectable Viral Load at Delivery. Clin Infect Dis. 2023 Feb 8;76(3):e590-e598. PMID: 36037040
Related Guidelines and Guidance:
- American College of Obstetricians & Gynecologists (ACOG): Optimizing Postpartum Care. Committee Opinion Number 736. May 2018.
- U.S. Department of Health and Human Services (DHHS): Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States(June 2025)
- New York State Department of Health AIDS Institute Clinical Guidelines Program:
- HIV Testing During Pregnancy, at Delivery, and Postpartum
- NYS Good Practices to Prevent Perinatal HIV Transmission
- Guidance: Questions, Answers, and Best Practices for Medical Management of Perinatal HIV Exposure in New York State
- U=U Guidance for Implementation in Clinical Settings
- PrEP to Prevent HIV and Promote Sexual Health
Resources:
- Antiretroviral Pregnancy Registry
- CDC HIV Hotlines and Warmlines > Perinatal HIV Hotline: Provides clinicians with around-the-clock advice on indications and interpretations of HIV testing in pregnancy, and consultation on antiretroviral use during pregnancy, labor and delivery, and the postpartum period. 1-888-448-8765 (24 hours, seven days a week)
- Edinburgh Postnatal Depression Scale