In pregnancy, how does ART affect maternal outcomes and the risk of transmitting HIV to the baby?

• A. ART worsens maternal outcomes and increases transmission
• B. ART improves maternal outcomes and reduces transmission
• C. ART has no effect on pregnancy outcomes
• D. ART should be avoided during pregnancy

Answer: (B)

Antiretroviral therapy during pregnancy works by suppressing HIV replication, which both improves the mother’s health and dramatically reduces the risk of transmitting the virus to the baby. When the viral load is kept low, the amount of virus in blood and genital secretions drops, decreasing the chance that the baby will acquire HIV during pregnancy, labor, delivery, or breastfeeding (if breastfeeding occurs). This is why ART is started as early as possible in pregnancy and continued adherently to maintain viral suppression, leading to better maternal outcomes and a much lower risk of mother-to-child transmission. While individual drugs have safety considerations, the overall effect of ART in pregnancy is beneficial for both mother and child.