HIV test in pregnancy

Photo of a gynecologist with a pregnant woman
PantherMedia / Dmitriy Melnikov

This information explains 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, you can contact your local health department or AIDS information center.

The key points:

  • HIV can be passed on to babies during pregnancy, birth and breastfeeding.
  • For this reason, it’s 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.

You have the right to have an HIV test. You can, of course, choose not to have one.

What is HIV?

HIV (human immunodeficiency ) infects cells of the body’s and destroys them. Most people who have HIV don’t notice any symptoms for years. But if the immune system 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 to prevent AIDS developing from HIV. There is currently no cure for HIV/AIDS.

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

Why have I 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’s 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 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 reduce 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 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.
  3. 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 pumped breast milk either. Standard formula milk can be used as a safe alternative.
  4. 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 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. 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 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 won’t 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 fact that you have talked with your doctor about the HIV test will be noted in your “Mutterpass” (medical record booklet during pregnancy). But this booklet won’t 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 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 virus 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 that there is 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?

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

Chou R, Smits AK, Huffman LH, Fu R, Korthuis PT, US Preventive Services Task Force. Prenatal screening for HIV: A review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2005; 143(1): 38-54.

Chou R, Cantor A, Bougatsos C, Zakher B. Screening for HIV in pregnant women: Systematic review to update the U.S. Preventive Services Task Force Recommendation. November 2012. (AHRQ Evidence Syntheses).

Coutsoudis A, Dabis F, Fawzi W, Gaillard P et al. Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis.

Deutsche AIDS-Gesellschaft (DAIG) et al. HIV-Therapie in der Schwangerschaft und bei HIV-exponierten Neugeborenen. S2k-Leitlinie. AWMF-Registernr.: 055-002. May 2014.

Forbes JC, Alimenti AM, Singer J, Brophy JC, Bitnun A, Samson LM et al. A national review of vertical HIV transmission. AIDS 2012; 26(6): 757-763.

Horvath T, Madi BC, Iuppa IM, Kennedy GE, Rutherford G, Read JS. Interventions for preventing late postnatal mother-to-child transmission of HIV. Cochrane Database Syst Rev 2009; (1): CD006734.

Read JS, Newell MK. Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1. Cochrane Database Syst Rev 2005; (4): CD005479.

Robert Koch-Institut (RKI). RKI-Ratgeber für Ärzte. HIV/AIDS. December 20, 2013.

Siegfried N, van der Merwe L, Brocklehurst P, Sint TT. 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.

World Health Organization (WHO). Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Recommendations for a public health approach (2010 version). Genf: WHO Press; 2010.

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. informedhealth.org 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?

Updated on December 17, 2014
Next planned update: 2021

Authors/Publishers:

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

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