How to manage pregnant women with HIV?
Dec 03, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
HIV-positive pregnant women should receive management through antiviral treatment during pregnancy, scientifically selected delivery methods, prevention of neonatal exposure, postnatal feeding guidance, and mother-infant follow-up care. The core objective is to block mother-to-child transmission of the virus and ensure the health of both mother and child. If a pregnant woman is diagnosed with HIV or has a high-risk exposure, she should seek immediate medical care for professional diagnosis and treatment.
Women with HIV/AIDS need comprehensive management during pregnancy and after delivery, including antiviral treatment during pregnancy, scientifically determined mode of delivery, prevention of neonatal exposure, postnatal feeding guidance, and mother-infant follow-up care. The core goal is to block mother-to-child transmission of the virus and ensure the health of both mother and child. If a pregnant woman is diagnosed with HIV or has high-risk exposure, she should seek medical care immediately for professional diagnosis and treatment.
1. Antiviral Treatment During Pregnancy: Initiate standardized antiviral therapy as early as possible after diagnosis. Use drug regimens proven safe for both mother and fetus to continuously suppress viral replication, reduce viral load, and minimize the risk of intrauterine fetal infection. Regular monitoring of viral load and liver and kidney function is required throughout treatment.
2. Scientific Selection of Delivery Method: Based on assessment of viral load, gestational age, and other factors, choose either vaginal delivery or cesarean section appropriately. Avoid prolonged labor and fetal distress during delivery to reduce the newborn’s exposure to maternal blood and secretions, thereby lowering the risk of intrapartum infection.
3. Prevention of Neonatal Exposure: Administer HIV immunoglobulin and initiate short-term antiviral prophylaxis to the newborn as soon as possible after birth. Complete the full course of preventive medication according to guidelines. Strictly avoid exposing the newborn to the mother’s blood or body fluids, and adhere to sterile procedures at all times.
4. Postnatal Feeding Guidance: Breastfeeding is strictly prohibited. Infant formula that meets national standards is recommended for artificial feeding. Mothers should be instructed on proper formula preparation and feeding techniques to prevent increased infection risk due to mixed feeding or improper practices.
5. Mother-Infant Follow-Up Management: After delivery, mothers should continue antiviral therapy and undergo regular check-ups including viral load and CD4 cell count monitoring. Newborns should be tested for HIV at key time points such as at birth, 4 weeks, and 8 weeks, with ongoing health monitoring.
Postpartum, mothers should maintain a regular lifestyle, eat a balanced diet to strengthen immunity, strictly adhere to prescribed medications without self-discontinuation, practice good personal hygiene and protection, avoid direct contact with the newborn through blood or body fluids, and maintain a positive mindset while actively participating in long-term follow-up and health management.
