Fact sheet: HIV Test in Pregnancy

I am pregnant. Why are all pregnant women offered an HIV test?

This fact sheet explains why every pregnant woman in Germany is given the option of having an HIV test. We hope that it is of help to you during antenatal appointments with your doctor. If you have further questions you can contact your local health authority or other health information centers.

The key points:

• HIV can be transmitted to babies during pregnancy, birth and breastfeeding.
• There is a very good chance of preventing the baby from being infected with HIV if measures are taken in time. It is therefore important to detect HIV infection early.
• It is possible to have an anonymous HIV test.

You have the right to have an HIV test.

Of course, you can also choose not to have an HIV test.

What is HIV?

HIV (human immunodeficiency virus) infects cells of the body’s immune system and destroys them. Most people who have HIV do not notice any symptoms for years. But when the immune system has been greatly weakened by the virus, serious illnesses develop. This phase of the HIV infection is called “AIDS” (acquired immunodeficiency syndrome). Although the treatment options have improved, there is currently no cure for AIDS.

Women usually contract HIV through unprotected sexual activity in which infected sperm fluid or blood enters their body, as well as by sharing needles and syringes.

Why have I been offered an HIV test?

In Germany, only very few pregnant women have HIV. But sometimes a woman might not know that she is infected.

If a pregnant woman has HIV, it does not mean that she will definitely pass it on to her child. However, there is a risk that the child could become infected. It is nearly always possible to protect a child from the virus if his or her mother knows early on during pregnancy that she has HIV. The treatment options available nowadays are so good that mothers with HIV often have no symptoms for a long time, which means they can also be there for their child. That is why it is important for pregnant women to know whether they have HIV.

How can my child be protected if I have HIV?

If HIV-infected women and their specialists do the following three things, it is very unlikely that the woman’s child will become infected with HIV too:

     1. During pregnancy: take medication which fights the viruses
     2. During the birth: have the baby delivered by caesarean section
     3. After the birth: do not breastfeed the baby

Could I contract HIV during pregnancy?

It is also possible for a woman to become infected with HIV during pregnancy. Using condoms during sexual activities provides good protection.

Are there any consequences of HIV tests I should know about?

For most women, an HIV test is only one of many tests which they have done when they are pregnant. However, it is not always easy to decide whether to have an HIV test. Some women might find it frightening. Waiting for the test results could be a stressful time. If you are concerned or worried you can talk to your doctor or contact a health information center. You can do this anonymously if you like

People who have HIV and know about it may face certain disadvantages, for example when taking out (life) insurance. But having a test done, and the outcome of a test, will not affect your statutory health insurance status or the residence permits of immigrants in Germany.

Who will know if I have the test done?

Your doctor will inform you of the test results during a confidential talk. Doctors and their staff will also keep all of your information confidential.

The HIV consultation and, if you decide to have it done, the HIV test will not be documented in your maternity records.

Can I have a test done anonymously?

Yes, you can be tested anonymously. For example, at a doctor’s practice, your local health authority, some AIDS information centers or a tropical medicine institute.

You are the only person who will be given the test results. You can decide who to tell about the test and outcome.

What happens during an HIV test?

An HIV test is done by taking a blood sample, which is then analyzed in a laboratory. The virus can only be diagnosed if the body has already started fighting the infection. If someone becomes infected, it takes a while before the virus is clearly detectable. This time period is called the diagnostic window. In most people HIV can be detected three months after they are infected.

If you think that there is a chance you may have contracted HIV, for example if you had unprotected sex, you can contact your doctor to arrange one or more appointments to have a test done. HIV tests are very accurate. If the blood sample analyzed in the laboratory shows that an HIV infection is present, a second test is carried out just to be sure.

How much does an HIV test cost?

HIV tests that are done in a doctor’s practice during pregnancy are paid for by health insurance funds. If you would like to have a test done anonymously you may have to pay a small fee yourself.

Where can I find more information?

Your doctor or local health authority will be able to provide you with further information.

The German Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung or BZgA) has a German-speaking information hotline, which you can call on 01805 555 444.

The BZgA website also provides the addresses of other information centers and an anonymous online information service (www.aidsberatung.de).

© IQWiG (Institute for Quality and Efficiency in Health Care)