What Should a Woman Do If She Tests HIV-Positive?

A woman who tests positive for HIV should take steps to protect her own health and the health of others. The CDC recommends that people with HIV infection:

• Promptly seek care from a physician or medical service, even if they feel well. Early treatment, preferably under the guidance of a doctor with experience treating people with HIV, can help slow damage to the immune system, prevent life-threatening conditions, and prolong life.

• Adopt a healthy lifestyle. Eating a balanced diet, exercising regularly, and getting enough sleep can help women with HIV stay healthy. Cigarette smoking, excessive alcohol consumption, and using illegal drugs such as cocaine can weaken the immune system.

There are many places where a woman can turn for information and support, such as:

• The CDC's National AIDS Hotline offers general information about treatments, practical advice on maintaining health, and referrals to local AIDS organizations and healthcare professionals who are knowledgeable about HIV and AIDS.

• Publications and referrals are also available from the CDC's National Prevention Information Network, which operates the National AIDS Clearinghouse.

How Does HIV Affect a Woman's Birth Control Choices?

HIV-infected women who are using or plan to use birth control should consult with their physician or a family planning clinic for information about contraceptive methods.

The only birth control method that is considered highly effective in reducing the transmission of HIV and other STDs is the condom (excluding lambskin condoms), as long as it is used correctly and consistently. Women who are using other methods, such as oral contraceptives (the "pill") or Depo-Provera injections, must also use condoms and/or other latex barriers during sexual activities to reduce the risk of transmitting HIV to a partner.

Women should also be aware that some medications that are used to treat HIV and HIV-related opportunistic infections can interact with birth control pills or other hormonal contraceptives and reduce their effectiveness.

Federally funded programs are available that provide family planning services (including birth control information, condoms and other contraceptives, and physical examinations) for those who cannot afford them. Women can consult their city health department or family-planning clinic for more information about these programs.

Having Sex With an HIV-Negative Partner

An HIV-positive woman should inform an HIV-negative sexual partner about her HIV diagnosis, so that steps can be taken to safeguard her partner's health and reduce future risk of HIV transmission. Such safeguards include "safer sex" practices-activities that reduce the risk of transmitting HIV and other sexually transmitted diseases to an uninfected partner.

Activities that pose no risk of HIV transmission include:

• Dry kissing and hugging

• Massaging each other

• Using a clean vibrator or dildo (or one that has been covered with a new condom) on each other

Activities that are considered relatively safe, but which may pose some risk of HIV transmission include:

• Vaginal and anal sex with a properly used latex condom

• Oral sex with a latex barrier (a condom to cover the penis or a dental dam to cover the vagina)

• Inserting a finger or hand, covered by a latex glove, in a partner's vagina or rectum

Having Sex With an HIV-Positive Partner

Even when a woman and her partner are both HIV-positive, safer sex practices are still needed to prevent each person from infecting the other with a different strain of HIV. These precautions are also needed to reduce the transmission of other sexually transmitted diseases, such as herpes or chlamydia infections.

HIV Infection and Pregnancy

About one-fourth of pregnant HIV-infected women in the United States who are not treated with the anti-HIV drug AZT (also called zidovudine) during pregnancy and childbirth transmit the virus to their babies before or during delivery.

HIV Infection and Breast-Feeding

HIV also may be transmitted from a nursing mother to her infant. Recent studies suggest that breast-feeding introduces an additional risk of HIV transmission of up to 14 percent among women with chronic HIV infection.

• Women who live in countries where safe alternatives to breast-feeding are readily available and affordable can eliminate the risk of transmitting the virus through breast milk by bottle-feeding their babies.

• In developing countries, however, where such safe alternatives are not readily available or economically feasible, breast-feeding may offer benefits that outweigh the risk of HIV transmission.