👶 Men's Health
HIV and Pregnancy — Preventing Mother-to-Child Transmission
How HIV-positive mothers can have HIV-negative babies in Nigeria
Mother-to-child transmission (MTCT) of HIV — also called vertical transmission — can occur during pregnancy, labour and delivery, or breastfeeding. Without treatment, the risk of transmission is 15–45%. With optimal antiretroviral therapy and appropriate feeding practices, transmission can be reduced to less than 1%. Nigeria has made significant progress through its Prevention of Mother-to-Child Transmission (PMTCT) programme, but gaps remain: late ANC booking, stock-outs of supplies, poor follow-up, and mixed feeding practices continue to result in preventable infections in newborns.
Signs and Symptoms
✓ HIV-positive pregnancy is not detected by symptoms — routine testing at ANC is essential
✓ All pregnant women should be tested for HIV at their first ANC visit (opt-out testing)
✓ Women who test negative but are at risk should be retested in the third trimester and at delivery
✓ Signs of AIDS in pregnancy (late, untreated HIV): weight loss, oral thrush, persistent cough
✓ Newborn HIV infection: pneumonia, failure to thrive, oral thrush — usually apparent by 6–8 weeks
When to Seek Help
Immediately on discovering pregnancyBook ANC early and test for HIV. If positive, start ART on the same day or within days
If already on ART and become pregnantDo not stop ART — continue immediately. Regimen review may be needed for pregnancy safety
Any signs of illness in HIV-positive pregnancyFever, cough, diarrhoea, weight loss — opportunistic infections are more dangerous in pregnancy and need prompt treatment
At deliveryInform the delivery team of HIV status so appropriate newborn prophylaxis can be given immediately (within 6–12 hours of birth)
At 4–6 weeks after delivery (infant)Infant HIV PCR (DNA) test at 4–6 weeks of age — standard of care in Nigeria PMTCT programme
Tests & Diagnosis
🧪 Maternal HIV test at first ANC
All pregnant women — opt-out testing. Reactive result confirmed with second rapid test
🧪 Maternal viral load
At ART start and at 34–36 weeks — high viral load near delivery informs decision about caesarean section
🧪 CD4 count
At diagnosis — guides prophylaxis decisions and opportunistic infection risk
🧪 Infant HIV DNA PCR
At 4–6 weeks of age (not standard antibody test — maternal HIV antibodies persist in baby until 18 months, making antibody tests unreliable early)
🧪 Infant HIV test at 9 months
Second PCR test — especially important if breastfed
🧪 Final HIV antibody test at 18 months
Confirms HIV-negative status once maternal antibodies have cleared
Frequently Asked Questions
If I'm positive, will my baby definitely get HIV?
With proper treatment, almost certainly not. With optimal ART throughout pregnancy and breastfeeding, and infant prophylaxis, the risk of transmission is less than 1%. The vast majority of HIV-positive mothers in Nigeria who receive PMTCT care have HIV-negative babies.
Can I breastfeed if I'm HIV positive?
Yes — this is the WHO and Nigerian government recommendation. Breastfeeding with maternal ART (ensuring undetectable viral load) is safer than formula feeding in a Nigerian context where clean water access, poverty, and other infections make formula-fed infants more vulnerable. Mixed feeding (breast + formula) is the worst option and must be strictly avoided.
What if I only found out I was HIV positive during labour?
You can still receive a single dose of nevirapine (sdNVP) during labour, and the baby receives nevirapine syrup from birth. This emergency regimen significantly reduces transmission even when started late. Start lifelong ART as soon as possible after delivery.
Will my partner need to be tested?
Yes. Partner HIV testing is strongly recommended — for the partner's own health and to identify whether they need treatment or PrEP. Couples counselling is available at all PMTCT sites. If the partner tests negative, they may be eligible for PrEP.