HIV test in pregnancy

Photo of a gynecologist with a pregnant woman

This article is about why all pregnant women in Germany are offered an HIV test. It is intended to help you during appointments with your doctor. If you have further questions, there are various organizations that offer advice and support, such as your local health department or AIDS information center.

The key points:

  • HIV can be passed on to babies during pregnancy, birth and breastfeeding.
  • It is important to detect an HIV as soon as possible. If treatment is started early enough, there’s a good chance that mother-to-child can be prevented. Even if an HIV is only detected later in the pregnancy, treatment can still protect the baby.
  • It is possible to have an anonymous HIV test.

All pregnant women have the right to have an HIV test. But they can, of course, choose not to have one.

What is HIV?

HIV (human immunodeficiency ) infects cells of the body’s immune system and destroys them. Most people who have HIV don’t notice any symptoms for years. But if the has been greatly weakened by the , serious illnesses develop. This stage of HIV is referred to as AIDS (acquired immune deficiency syndrome). Lifelong treatment with medication can help prevent an HIV from developing into AIDS. There is currently no cure for HIV/AIDS.

Women are most commonly infected during unprotected sexual contact where blood or semen (the fluid that contains sperm) get into their body. HIV can also be spread by sharing needles.

Why have you been offered an HIV test?

Only very few pregnant women in Germany have HIV. But sometimes women might not know that they are infected.

It is important to know whether you have HIV because the can be passed on to the child. A pregnant woman who has HIV can prevent her child from being infected by taking medication over the entire pregnancy. This lowers the risk of to below 1%. The treatment options available nowadays are so good that mothers with HIV often have no symptoms and can be there for their child.

How can you protect your child if you have HIV?

The following things can greatly reduce the chances of passing HIV on to the baby:

  • 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.
  • Adapting your birth plans: If the treatment was successful, it will be possible to deliver the baby naturally. If you haven’t been taking any medication or if the medication wasn’t effective, a Cesarean section can greatly lower the risk of transmission.
  • Not breastfeeding the baby. Breast milk can contain HIV as well as some of the medication. For this reason, the baby shouldn’t be given expressed (pumped) breast milk either. Standard formula milk can be used as a safe alternative.
  • Getting treatment for the baby after giving birth.

Is it possible to get HIV during pregnancy?

Women can also become infected with HIV during pregnancy. Using condoms during sexual activities provides good protection.

Are there any negative consequences of HIV tests?

For most women, an HIV test is only one of many tests that they have done when they are pregnant. It is not always easy to decide whether to have an HIV test, though, and the decision can be frightening. Waiting for the test results can also be stressful. You can talk with your doctor or contact an AIDS information 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 getting the results won’t affect your statutory health insurance or residence status.

Who will know if you have the test done?

The doctor will tell you the test results during a private appointment. Doctors and their staff are required to keep all of your information confidential. The results won’t be given to your employer or any other institution.

You can decide who to tell about the test and the outcome. Other doctors will only receive the results with your consent.

The fact that you have talked with your doctor about the HIV test will be noted in your “Mutterpass” (medical record booklet during pregnancy). If you have the test, that will be noted there too. But the booklet won’t include any information about the test results.

Can you have a test done anonymously?

It is possible to be tested anonymously. This can be done in various places, including at a doctor’s practice, at hospitals with an outpatient HIV department, your local health authority, some AIDS information centers or at a tropical medicine institute.

What do HIV tests involve?

HIV tests involve taking a blood sample, which is then examined in a laboratory. The can only be detected if the body has already started fighting the . HIV can usually be detected in the blood three months after 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 viruses in their blood.

If you think there’s a chance you may have contracted HIV – for example, if you’ve 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?

Statutory health insurers cover the costs of HIV tests that are done in a doctor’s practice during pregnancy. 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.

In Germany, the Federal Center for Health Education (BZgA) offers an anonymous German-language hotline at (0)221 / 892031.

The BZgA website also provides the addresses of other information and counseling centers, as well as an anonymous online information service:

Chou R, Cantor A, Bougatsos C et al. Screening for HIV in pregnant women: Systematic review to update the U.S. Preventive Services Task Force Recommendation. (AHRQ Evidence Syntheses; No. 96). 2012.

Deutsche AIDS-Gesellschaft (DAIG). Deutsch-Österreichische Leitlinie zur HIV-Therapie in der Schwangerschaft und bei HIV-exponierten Neugeborenen (S2k-Leitlinie). AWMF-Registernr.: 055-002. 2020.

Gemeinsamer Bundesausschuss (G-BA). Mutterschaftsrichtlinien (Richtlinien über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung). 2022.

Horvath T, Madi BC, Iuppa IM et al. Interventions for preventing late postnatal mother-to-child transmission of HIV. Cochrane Database Syst Rev 2009; (1): CD006734.

Siegfried N, van der Merwe L, Brocklehurst P et al. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev 2011; (7): CD003510.

Sturt AS, Dokubo EK, Sint TT. Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women. Cochrane Database Syst Rev 2010; (3): CD008440.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

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Updated on September 21, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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