During the first antepartal visit, a client who is at 10 weeks' gestation learns of being HIV positive. Which client statement indicates an understanding of the plan of care both during the pregnancy and postpartally?
1. "I should not breastfeed my baby."
2. "When my baby is 2 months old, he or she will be tested for HIV."
3. "If I have a cesarean section, there is an increased risk that my HIV will be passed to my baby."
4. "I am supposed to take highly active antiretroviral therapy (HAART), but only during the first trimester."
1
Explanation:
1. HIV transmission can occur during pregnancy and through breast milk; however, it is believed that the majority of all infections occur during labor and birth.
2. Following birth, HIV infection in infants should be diagnosed using HIV virologic assays as soon as possible, with initiation of infant antiretroviral prophylaxis immediately if the test is positive.
3. Cesarean section reduces the transmission of HIV from mother to infant.
4. Longer duration therapy is preferable to shorter duration approaches, and it is best to start prophylaxis after the first trimester and no later than 28 weeks' gestation in women who do not require immediate therapy for their own health.
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