How does an HIV-positive mother transmit the virus to her child? Here is a comparison, common infectious diseases such as hepatitis B and C are mainly transmitted during delivery, while 80% of syphilis newborns are infected during pregnancy. Both syphilis and hepatitis B mothers can breastfeed, while unfortunately HIV can be transmitted during pregnancy, delivery and breastfeeding, so only HIV mothers clearly cannot breastfeed. How to fertilize a man who is negative for the virus and a woman who is positive? What about both partners being positive? Fertilization with a negative male partner and a positive female partner is not complicated because the probability of a man being infected when he has sex with a sick woman is very low; the same is true if both partners are positive. The difficulty of mother-to-child interruption is mainly on the mother. The couple can control the viral load and have normal sex. Does pregnancy aggravate AIDS? Is it true that HIV positive pregnant women have less resistance, such as being prone to illness during pregnancy? A woman’s pregnancy will not aggravate the course of AIDS, and in turn AIDS will not affect a woman’s pregnancy complications. Whether a woman is prone to fever or not is still determined by her immune function and physical condition. If the patient is relatively healthy, the chances of getting a cold are actually no different from those of a normal pregnant woman. I would like to emphasize that AIDS itself and the blocking drugs have no effect on the fetus and do not increase the malformation rate of newborns because of AIDS. How often should I be reviewed during pregnancy and what tests should I have each time? Just like normal pregnant women, you should have a normal pregnancy test at 3 months and 6 months, and you should also check CD4, viral load and other disease indicators, and have your viral load measured about 4 weeks before delivery to decide the mode of delivery. Because therapeutic drugs still have certain toxic side effects, we also monitor for adverse reactions in the digestive tract, whether diarrhea is present, whether anemia is worsening, and so on. To assess the degree of disease development, we need to look at viral load, immune function, and related toxic tests such as hematocrit, liver and kidney function, lipids, etc., and adjust the medication according to these indicators. Emphasis is placed on the fact that pregnant women with HIV will not be induced regardless of the viral load test, unless the patient has serious complications and cannot tolerate the pregnancy, and then abortion should definitely be induced as soon as possible. In the most severe cases I have seen, there was a pregnant woman with a viral load of 4 million and another with a CD4 of just over 40, but they both gave birth to healthy children. Does an HIV-positive mother have to take medication throughout her pregnancy? Regardless of the CD4 level, HIV-positive women should continue to take medication during pregnancy preparation, pregnancy, and up to postpartum, and these medications have no effect on the fetus. Taking the medication can inhibit the proliferation of HIV virus and reduce the viral load; if you don’t take the medication, you will increase the chance of your child getting infected, and also increase the possibility of drug resistance in pregnant women, as well as a variety of HIV complications, etc. If the side effects of the medication are severe, the doctor can switch the patient to a medication with fewer side effects and increase the number of follow-up appointments accordingly. Patients should not stop taking the medication on their own because they feel uncomfortable after taking it. And it is important to emphasize that AIDS medication must be taken at the right time, twice a day. For example, if you take your medication at 8:00 a.m. and 8:00 p.m. today, you should also take it at that time tomorrow, which will reduce the possibility of drug resistance. Birth process for AIDS mothers AIDS is only 30 years old since its discovery and is considered a very new disease, so treatment guidelines are always changing. In the earliest days, AIDS mothers requested a cesarean section, but this concept changed five years ago. The mother needs to have her viral load checked about four weeks before her due date to determine the mode of delivery: if the viral load is less than 1,000 or undetectable, then the delivery can be normal if there are no obstetric complications based on the obstetrician’s assessment; if the viral load is greater than 1,000, a cesarean section is required to reduce the rate of infection in the newborn. Cesarean delivery can cause many obstetric complications, and if the pregnant woman’s immune function is a little worse, other infections can occur; normal delivery has fewer complications, less cost, and less damage to the patient. The difference in the rate of transmission between normal delivery and cesarean delivery is not significant, but the surgical indications for cesarean delivery are relaxed for HIV-positive women. Usually, women who are assessed to have a difficult normal delivery and may not be able to give birth and need lateral incision or forceps should choose cesarean delivery because lateral incision and other methods will increase the chance of infection in the newborn; however, there is a prerequisite for choosing cesarean delivery, try to be prepared to choose a good date for the operation, do not wait until you are about to give birth and then have an emergency cesarean delivery, trying to have a failed natural birth will definitely increase the chance of infection. In terms of data, the cesarean delivery rate in Beijing is 45 to 50% for ordinary mothers, while 80% of pregnant women with AIDS choose to have a cesarean delivery.