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Pregnant and just tested positive on the routine HIV test
Nov 10, 2005

I am pregnant and part of the labs I had to get drawn was a HIV test. I was shocked when I came up positive. I even made them test it again, because I was sure they mislabeled a tube. Still positive. I have never used drugs and only had sex with my husband. I tried to tell him he was HIV positive, but he told me I was lying and must have had an affair. I don't know what to do--my OB doctor now won't treat me and I have no idea what care I should get. I really don't want to get an abortion. I have a few questions. What kind of doctor should I look for? I have read that I should have an HIV specialist--are there HIV specialists that are also OB doctors or would I have to get an OB doctor and an HIV specialist working together. Also, I am in my first trimester--I know you can go on the antiretrovirals, but are they safe for me at this time? What are the statistics on my chances of passing this to my baby? Thanks. --Allison

Response from Dr. Frascino

Hello Allison,

I'm sorry to hear about your recent positive HIV test; however, if you've had absolutely no risk exposures for HIV (no blood transfusions, sharing of intravenous drug paraphernalia, unprotected sex) other than sex with your husband, I agree there can be only two possible conclusions:

1. Your husband is HIV positive and transmitted the virus to you.

2. Your test is a false positive.

Either way, I see no reason for you to even consider abortion, if you want to have this child. Even if you are HIV positive, with proper care and medications, the risk of transmitting the virus to your unborn child would be minimal.

The first thing you should do is establish care with an HIV/AIDS specialist. If you are writing form the U.S., I'd suggest you check the American Academy of HIV Medicine's Web site at www.aahivm.org. They have a list of HIV/AIDS specialists by locale. (Click on "Find a Provider.") The HIV specialist will first determine if your tests were accurate or not by performing other confirmatory tests. If you are HIV positive, the specialist will refer you to an HIV-knowledgeable OB doctor who will help you through the pregnancy. Together these physicians will explain when and what medications to consider and what precautions to take to minimize the risk of transferring the virus to your baby.

That your initial OB doctor refused to treat you is shocking. If it were up to me, his license to practice medicine would be revoked. I'd suggest reporting him to your local medical society and also advising local AIDS service organizations of his refusal to treat you. Discrimination such as this is blatantly immoral.

To answer your question about statistical risk, in North America and Western Europe studies report as few as 2% of infants born to HIV-positive moms turn out to be HIV-infected, which is due to antiretroviral medications and other interventions.

Good luck, Allison. Write back and let us all know how you are doing or if you have additional questions. O.K.?

Dr. Bob



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