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Newly Infected woman
May 17, 2000

First of all, thank you for this wonderful site.

I have been positive for 15 years and am male. My sister recently (last week) tested positive. She was negative at this time last year. I really do not know what to tell her about getting started. She is frightened about starting medication as she has watched my progression through the drugs (which did not come available until several years after I tested positive). Please help me in telling her where to start. She doesn't want me to tell anyone so I'm having a hard time trying to get basic questions answered. Are there differences in our situations based on gender? She is still of child bearing age (35). Is it possible for her to still have children? Does the age of testing positive have any bearing? (I was 17.) Should she be tested again? She has a really hard time taking a vitamin everyday so she is a bit reluctant to start medications that require so much commitment. She sees that I am doing alright, with nothing major other than side effects, so she sees no immediate need to start treatment. I have encouraged her to see an Infectious Disease doctor but not until she knew the right questions to ask.

I would really like for her to not have to go through what I did, mostly learning as you go, and with all the new stuff out there, I don't know what the proper advice should be. She is looking to me to answer a lot of questions and I am doing my best but perhaps you could be of assistance.

Thank you for your time.

Response from Dr. Jackson

In general, HIV infection in women is not much different than that in men. For both men and women it is important to be evaluated by a physician knowledgeable in HIV infection. Such an evaluation should include confirmation of the HIV infection, a history, physical exam, and laboratory testing including an HIV viral load and CD4 cell count. Her physician should then discuss treatment options with her. Older adults such as your sister are more likely to progress to AIDS faster from the time of infection compared with young adults. Women, who are HIV infected, are at particularly high risk for cervical cancer and should have a PAP smear. HIV infection does not preclude women of child bearing age from becoming pregnant. However, prematurity and low birth weight are more common among newborns of HIV infected women. The risk of an HIV infected mother transmitting HIV is greater the higher the maternal viral load (plasma HIV RNA), but on average is about 25% in the absence of antiretroviral treatment. With treatment the risk can be reduced substantially to less than 5%. Likewise C-section can reduce the risk of transmission by more than half.

Brooks Jackson, M.D.

Passing HIV to Children
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