The Centers for Disease Control and Prevention (CDC) estimates that around 1.2 million peopleTrusted Source in the United States have HIV. Around 40 percent may not even know they’ve contracted the virus. This means that there may many women in their reproductive years who are HIV positive but do not know it.
Advances in treatment for HIV make it a manageable condition. Even better, prompt treatment can also prevent transmission of the virus to babies in most cases, per the CDCTrusted Source.
Is HIV testing during pregnancy necessary?
The American College of Obstetricians and Gynecologists (ACOG) recommends that all women are tested for HIV during pregnancy or before thinking of getting pregnant. Why? HIV can go undetected for years before it causes symptoms.
A pregnant person with HIV who is not treated can pass the virus to an unborn baby, according to the U.S. Department of Health and Human Services.With treatment, though, the chances of passing along HIV to a baby are very low. Getting treatment for the viral infection will also help ensure a healthy pregnancy, delivery, and future. The earlier the virus is detected, the better the treatment can work.
What is HIV?
HIV is a virus that affects disease-fighting T cells in the immune system. When these cells are not working properly, infections, cancers, and diseases can more easily cause illness.
HIV is passed from person to person through contact with body fluids — blood, breast milk, and semen — and is considered a sexually transmitted infection (STI) because one of the main routes of transmission is through sex without a condom or other barrier method.
Another primary route of transmission is through sharing needles with a person who has HIV. Any other activity that can expose an individual to body fluids containing HIV may also lead to transmission of the virus.
Without treatment, HIV can become stage 3 HIV, or AIDS. However, it may take several months or years for the virus to progress, according to the National Institutes of Health.
That said, there is no cure for HIV. It’s a chronic illness. Treatment focuses on managing the virus and keeping the viral load low. Viral load is just another way of saying how much virus is in the body.
Early detection is key, especially during pregnancy. While having a low viral load may reduce the chances of passing the virus to an unborn child, an infant may contract the virus.
HIV symptoms during pregnancy
Symptoms in the beginning stages of HIV may be hard to spot. Symptoms of acute infection may begin around 2 to 4 weeks after first exposure to the virus. Symptoms are similar to those of the flu.
Symptoms of HIV may include:
fever and chills
joint pain or muscle aches
swollen lymph nodes
ulcers in the mouth
other vaginal infections
menstrual cycle changes
Not everyone has symptoms in this stage, though, so experts recommend testing whenever contact with the virus is suspected. After initial symptoms, the virus enters the clinical latency stage. This stage of the virus can last between 10 to 15 years and may produce few or no symptoms.
What types of HIV tests are available during pregnancy?
Testing for HIV in pregnancy is the same testing that’s offered to non-pregnant people. The first-line tests screen the blood or saliva for antibodies and antigens — these are proteins in the blood that fight infection.
This blood test can detect HIV just 18 to 45 daysTrusted Source after initial exposure. It looks for both the HIV antibodies and antigens present in the blood. Both standard and rapid antigen/antibody tests are available. The rapid test uses a finger prick and may not detect the virus for up to 90 daysTrusted Source after exposure.
This blood or saliva test can detect HIV in 23 to 90 daysTrusted Source after initial exposure. Many rapid tests are antibody tests, including the at-home self-test. Antibody tests that are performed using blood from a vein detect HIV sooner than those done by finger prick or with saliva.
Nucleic acid tests (NATs)
This blood test can detect HIV in just 10 to 33 daysTrusted Source after initial exposure. It looks for the virus in the blood versus just the antibodies. NATs are expensive and are not usually the first test given unless there is a confirmed exposure to HIV or there are symptoms.
The specific test given may depend on:
the location where testing is performed
the conditions of exposure (confirmed versus suspected exposure)
whether an individual is symptomatic
how long ago exposed to the virus may have occurred
How are HIV tests done during pregnancy?
Many doctors and other healthcare professionals will offer routine testing for HIV at the first prenatal visit or as early as possible in pregnancy.
If there are other risk factors for acquiring HIV, such as a recent diagnosis of another STI, a new sexual partner during pregnancy, or a partner who has HIV, a doctor may also recommend being re-tested in the third trimester (around week 36) of pregnancy.
Testing is done via blood test or saliva screening. These methods are relatively noninvasive and offer results in an hour (rapid testing) to a few days. Re-testing may be necessary to confirm the diagnosis if the results are positive (results may take up to 2 weeks). Re-testing may also occur if the results are negative but an individual suspects they have been exposed to the virus.
How much do HIV tests during pregnancy cost?
How much an HIV test will cost has to do with a number of factors, including:
health insurance coverage
fees such as copays or deductibles
where the testing is done
Some clinics offer free testing. Others may provide tests at a reduced rate. Consider calling a doctor or clinic ahead of time to ask about associated costs.
Without insurance, STI test costs may range between $50 to $200 per test estimates Cost Helper. Over-the-counter tests are available for testing at home. For example, the Oraquick at-home HIV test runs around $40 per test.The HIV Services Locator can help find location-based HIV testing.