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HIV and Women

Preventing Mother-to-Child Transmission of HIV After Birth

(Last updated 8/17/2015; last reviewed 8/17/2015)

Key Points

  • The use of HIV medicines and other strategies have greatly reduced the rate of mother-to-child transmission of HIV. Fewer than 200 babies with HIV are born each year in the United States.
  • For 6 weeks after birth, babies born to women with HIV receive an HIV medicine called zidovudine (brand name: Retrovir). The HIV medicine protects the babies from infection with any HIV that passed from mother to child during childbirth.
  • HIV testing for babies born to women with HIV is recommended at 14 to 21 days after birth, at 1 to 2 months, and again at 4 to 6 months. The test used (called a virologic HIV test) looks directly for HIV in the blood.
  • Results on two virologic tests must be negative to be certain that a baby is not infected with HIV. The first negative result must be from a test done when a baby is 1 month or older and the second result from a test done when a baby is 4 months or older. Results on two HIV virologic tests must be positive to know for certain that a baby is infected with HIV
  • If testing shows that a baby has HIV, the baby is switched from zidovudine to a combination of HIV medicines. HIV medicines help children infected with HIV live healthier lives.  
  • Because HIV can spread in breast milk, HIV-infected women in the United States should not breastfeed their babies. In the United States, infant formula is a safe and healthy alternative to breast milk.

How many babies in the United States are born with HIV?

HIV can be passed from an HIV-infected mother to her child during pregnancy, childbirth, or breastfeeding (through breast milk). Fortunately, the use of HIV medicines and other strategies have greatly reduced the rate of mother-to-child transmission of HIV. Fewer than 200 babies with HIV are born each year in the United States.

The risk of mother-to-child transmission of HIV is low when:

  • Women with HIV receive HIV medicine during pregnancy and childbirth and, in certain situations, have a scheduled cesarean delivery (sometimes called a C-section).
  • Babies born to women with HIV receive HIV medicines for 6 weeks after birth and are not breastfed.

How soon after birth do babies born to women with HIV receive HIV medicines to prevent mother-to-child transmission of HIV?

Within 6 to 12 hours after birth, babies born to women with HIV receive an HIV medicine called zidovudine (brand name: Retrovir). In general, the babies receive zidovudine for 6 weeks. In certain situations, a baby may receive other HIV medicines in addition to zidovudine. The HIV medicine protects the babies from infection with any HIV that passed from mother to child during childbirth.

Once the 6-week course of zidovudine is finished, babies born to women with HIV receive a medicine called sulfamethoxazole/trimethoprim (brand name: Bactrim). Bactrim helps prevent Pneumocystis jiroveci pneumonia (PCP), which is a type of pneumonia that can develop in people with HIV. If HIV testing shows that a baby is not infected with HIV, the Bactrim is stopped. 

How soon after birth are babies born to women with HIV tested for HIV?

HIV testing is recommended at 14 to 21 days after birth, at 1 to 2 months, and again at 4 to 6 months. The test used (called a virologic HIV test) looks directly for HIV in the blood.

Results from at least two HIV virologic tests are needed to know whether a baby is HIV negative or HIV positive.

  • HIV-negative (not infected with HIV)
    To know for certain that a baby is not infected with HIV, results on two virologic tests must be negative. The first negative result must be from a test done when a baby is 1 month or older, and the second result from a test done when a baby is 4 months or older.
  • HIV-positive (infected with HIV)
    To know for certain that a baby is infected with HIV, results on two HIV virologic tests must be positive.

Fortunately, few babies in the United States are born with HIV because most pregnant women with HIV and their newborn babies receive HIV medicines. If testing shows that a baby is HIV positive, the baby is switched from zidovudine to a combination of HIV medicines (called antiretroviral therapy or ART). ART helps people with HIV live longer, healthier lives.

What other steps are used to protect babies from HIV?

Because HIV can spread in breast milk, women with HIV who live in the United States should not breastfeed their babies. In the United States, infant formula is a safe and healthy alternative to breast milk. 

There are reports of children becoming infected with HIV by eating food that was previously chewed by a person with HIV. To be safe, babies should not be fed pre-chewed food.

Do women with HIV continue to take HIV medicines after childbirth?

Women work closely with their health care providers to decide whether to continue taking HIV medicines after childbirth. Treatment with HIV medicines is recommended for everyone infected with HIV. HIV medicines prevent HIV from advancing to AIDS and reduce the risk of sexual transmission of HIV. 

A woman’s decision whether to continue taking HIV medicines after childbirth depends on the following factors:

  • Current recommendations for HIV treatment in adults
  • The level of HIV in her body (HIV viral load) 
  • Any issues that may make it hard for her to take HIV medicines exactly as directed
  • Whether her partner is infected with HIV
  • Her personal preferences and those of her health care provider

This fact sheet is based on information from the following sources:

From the Department of Health and Human Services: