The excitement of finding out you're pregnant can sometimes be overshadowed with worry about the possible health threats that could face you and your unborn baby. At your early prenatal visits, your doctor will ask you questions about your family medical history and your personal medical history. He or she will also discuss the prenatal tests recommended for you.

One routine test offered to pregnant women is HIV testing. You might feel shocked or embarrassed when your doctor suggests this test for you. But it's considered part of routine prenatal testing for all pregnant women. It's important to identify HIV-infected mothers to prevent the transmission of HIV to the baby.

You might think you are not at risk for HIV or may be afraid to find out your HIV status. While these thoughts are common, don't let your own fear or a false sense of security put your unborn baby's life and future at risk. Even if you have been tested before and found negative, testing again early in pregnancy is advised. Even if your risk is small, testing is still advised.

The facts about HIV
HIV can be passed from a mother to her baby during pregnancy, during labor or through breast-feeding.

• Mother-to-baby transmission of HIV accounts for 91 percent of all AIDS cases reported among children in the United States. With identification and treatment, most of these cases of transmission could be prevented.
• About 40 percent of the mothers of the HIV-infected infants did not know they had HIV before delivery.

How is HIV testing done?
HIV testing is done using a standard blood test or rapid tests.

Rapid tests are FDA-approved and require either a small sample of blood or saliva. A rapid test can yield results within a few minutes. A positive result means you need further testing but does not confirm that you have HIV. A positive rapid test is followed up with a more thorough blood test. Results for this may take a several days.

What if I am HIV-positive?
If you test positive for HIV and are pregnant:

• Your doctor will start treating you with antiretroviral medications right away.
• You will need to give birth via cesarean section, rather than vaginal birth. This further cuts the risk the virus will be transmitted to the baby.
• You won't be able to breast-feed. Breast-feeding is not advised for women with HIV, as the virus can be spread through the breast milk to the baby.

The combination of these actions can greatly reduce the chances that HIV will be transmitted from mother to baby.