Pregnant with preliminary positive result

Question

Hello,

My husband and I are 10 weeks pregnant, with our first child. As part of the initial blood test required, surprisingly my test result for HIV came out positive! We are both very scared and surprised, since we have been together for 5 years and are a very healthy couple (athletes, no drugs whatsoever, and monogamous). Thanks to your website we have read a lot of false positives in pregnant women giving us a little bit of faith. After the news, my husband went with me so I could get the western blot (to which I am impatiently waiting for results) and he got the faster test. Today I picked up his results and his are negative. My question is: If I was indeed HIV positive, and the only time I could have been infected was prior to dating him (which is hard for me to believe because I had never had unprotected sex before, marrying him)... wouldn't he be infected already? Are my chances of a false positive even higher because he is negative? Can I relax?

Thank you very much.

Answer

Hi,

This question comes up frequently in mixed serostatus couples. "How could he or she be negative if I'm HIV positive and we had lots of unprotected sex?" The answer is that every exposure to HIV does not lead to transmission of the virus (thankfully). For instance the CDC's estimated statistical per-act risk for acquiring HIV from unprotected insertive penile-vaginal sex with a partner confirmed to be HIV infected is 5 per 10,000 exposures. There are many factors that come into play regarding HIV transmission that involve both the virus (viral strain, viral load, etc.) and the host (immune system integrity, concurrent infections, local trauma, etc.).

Regarding your preliminary reactive (positive) test, it is most likely a false positive due to nonspecific cross-reacting proteins induced by your pregnancy. Yes, there are many similar stories in the archives. You had essentially no HIV risk; consequently, there is no reason for you to be HIV infected. I'm confident your confirmatory tests will confirm your HIV-negative status. Write back and let us know. I'll add your story to those already in the archives in the hope that it will help others who find themselves in a similar anxiety-provoking position.

Good luck.

Dr. Bob