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Pregnancy and birth: HIV test in pregnancy

Last Update: December 17, 2014; Next update: 2017.

This information is intended to help during antenatal appointments and describes why all pregnant women in Germany are offered an HIV test. If you have further questions you can contact your local health department or other AIDS support center.

The key points:

  • HIV can be transmitted to babies during pregnancy, birth and breastfeeding.
  • This makes it essential to detect any HIV infection as soon as possible. If treatment is started early enough there is a good chance that the baby can be kept from infection. Even when an HIV infection is first detected later in the pregnancy, treatment can still help to protect the baby.
  • It is possible to have an anonymous HIV test.

You have the right to have an HIV test. Of course, you can also choose not to have an HIV test.

What is HIV?

HIV (human immunodeficiency virus) infects cells of the body’s immune system and destroys them. Most people who have HIV do not notice any symptoms for years. But if the immune system has been greatly weakened by the virus, serious illnesses develop. This phase is referred to as "AIDS" (acquired immune deficiency syndrome). Lifelong drug therapy can help to prevent AIDS developing from HIV. With today's medicine it is not possible to cure HIV/AIDS.

Women are most commonly infected by semen or blood during unprotected sexual contact. HIV can also be transmitted by sharing needles.

Why have I been offered an HIV test?

In Germany, only very few pregnant women have HIV. But sometimes a woman might not know that she is infected.

It is important to know about any HIV infection, because the virus can be passed on to the child. A pregnant woman who has AIDS can keep her child from being infected by taking medication over the entire pregnancy. This method is effective and can lower the risk of infection to below 1%. The treatment options available nowadays are so good that mothers with HIV often have no symptoms for a long time, which means they can also be there for their child.

How can I protect my child if I have HIV?

The following things can help to greatly lower the chances of transmitting HIV to the baby:

  1. Taking anti-HIV drugs during pregnancy. If treatment is successful, the amount of HIV in the bloodstream drops so much that it is barely detectable.
  2. Considering this issue when deciding how to deliver the baby: If treatment was successful, it will be possible to deliver the baby naturally. If you are not taking any medication or if the medication has not been effective, a cesarean section can greatly lower the risk of transmission.
  3. Not breastfeeding the baby. Breast milk can contain HIV as well as some of the medication. Pumped breast milk should also not be given to the baby. Standard formula can be used as a safe alternative.
  4. Getting treatment for the baby after giving birth.

Is it possible to contract HIV during pregnancy?

It is also possible for a woman to become infected with HIV during pregnancy. Using condoms during sexual activities provides good protection.

Are there any consequences of HIV tests I should know about?

For most women, an HIV test is only one of many tests which they have done when they are pregnant. However, it is not always easy to decide whether to have an HIV test and the decision can be frightening. Waiting for the test results can also be stressful. You can talk with your doctor or a counseling center about any worries or concerns you have. This can be done anonymously if you prefer.

People who have HIV and know about it may face certain disadvantages, for example when taking out (life) insurance. But opting to have the test and its results will not affect your statutory health insurance or residence status.

Who will know if I have the test done?

Your doctor will inform you of the test results in private. Doctors and their staff are required to keep all of your information confidential. The results will not be given to your employer or any other institution.

Who you tell about the test and the outcome is entirely your decision. Other doctors will only receive the results with your consent.

The invitation to HIV testing will be noted in your medical records, but it will not include any information about whether you had the test or what the results were.

Can I have a test done anonymously?

You can be tested anonymously. This can be done at your doctor’s, at clinics with an HIV outpatient program, your local health authority, some AIDS information centers or at a tropical medicine institute.

What happens during an HIV test?

An HIV test is done by taking a blood sample, which is then analyzed in a laboratory. The virus can only be detected if the body has already started fighting the infection. HIV can usually be detected in the blood three months after infection at the latest.

The test result is "positive" if viruses are detected in the blood. The expression "HIV positive" is used to refer to a person who has HIV.

If you think that there is a chance you may have contracted HIV, for example if you had unprotected sex, you can contact your doctor to arrange one or more appointments to have a test done. HIV tests are very accurate.

How much does an HIV test cost?

HIV tests that are done in a doctor’s practice during pregnancy are covered by statutory health insurance. If you would like to have a test done anonymously you may have to pay a small fee yourself.

Where can I find more information?

You can get more information from your doctor, your local health authority, or an AIDS information center.

The German Federal Center for Health Education (BZgA) offers an anonymous German-language hotline at (01805)555444.

The BZgA website also provides the addresses of other information centers and an anonymous online information service: www.aidsberatung.de


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IQWiG (Institute for Quality and Efficiency in Health Care)

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