HIV During Pregnancy, Labor and Delivery, and After Birth

HIV Testing and Pregnancy

I am pregnant, and I may have HIV. Will I be tested for HIV when I visit a doctor?

In most cases, health care providers cannot test you for HIV without your permission. However, the U.S. Public Health Service recommends that all pregnant women be tested. If you are thinking about being tested, it is important to understand the different ways perinatal HIV testing is done. There are two main approaches to HIV testing in pregnant women: opt-in and opt-out testing.

In opt-in testing, a woman cannot be given an HIV test unless she specifically requests to be tested. Often, she must put this request in writing.

In opt-out testing, health care providers must inform pregnant women that an HIV test will be included in the standard group of tests pregnant women receive. A woman will receive that HIV test unless she specifically refuses. The CDC currently recommends that health care providers adopt an opt-out approach to perinatal HIV testing.

What are the benefits of being tested?

By knowing your HIV status, you and your doctor can decide on the best treatment for you and your baby and can take steps to prevent mother-to-child transmission of HIV. It is also important to know your HIV status so that you can take the appropriate steps to avoid infecting others (see Understanding HIV Prevention Fact Sheet).

What happens if I agree to be tested?

If you agree to be tested, your doctor should counsel you before the test about the way your life may change after you receive the test results. If the test indicates that you have HIV, you should be given a second test to confirm the results. If your second test is positive for HIV, you and your doctor will decide which treatment options are best for you and your baby (see Treatment Regimens for HIV Positive Pregnant Women Fact Sheet). If the test indicates that you do not have HIV, you may receive counseling on HIV prevention.

What happens if I refuse to be tested?

If you decide that you do not want to be tested for HIV, your doctor may offer you counseling about the way HIV is transmitted and the importance of taking steps to prevent HIV transmission. He or she may also talk to you about the importance of finding out your HIV status so that you can take steps to prevent your baby from becoming infected.

Will my baby be tested for HIV?

Health care providers recommend that all babies born to HIV positive mothers be tested for HIV. However, states differ in the ways they approach HIV testing for babies.

• some states require that babies receive a mandatory HIV test if the status of the mother is unknown
• some states require that health care providers test babies for HIV unless the mother refuses
• some states are only required to offer an HIV test to pregnant women (not their babies), which they can either accept or refuse
• some states have no specific requirements about testing pregnant women or their babies.

How can I find out the testing policies of my state?

The U.S. Department of Health and Human Services (HHS) can provide you with HIV testing information for your state. Contact HHS at 1?877?696?6775 or 202?619?0257.

Terms Used in This Fact Sheet CDC (Centers for Disease Control and Prevention): an agency of the U.S. Federal government that focuses on disease prevention and control, environmental health, and health promotion and education. www.cdc.gov. Mother-to-child transmission: the passage of HIV from an HIV positive mother to her infant. The infant may become infected while in the womb, during labor and delivery, or through breastfeeding. Also known as perinatal transmission. Perinatal HIV testing: testing for HIV during pregnancy or during labor and delivery.