Early HIV testing in pregnancy crucial for safe deliveries, says doctor

By Admin

08 Dec, 2025

India stands at a critical juncture in its ongoing battle against HIV, with health experts warning that delayed testing especially during pregnancy could deepen an already growing health challenge. Health specialists say the warning signs are already visible, and unless we act now, everyday habits and systemic gaps could quietly push the country into a larger health crisis than expected.

In India’s long fight against HIV, vertical transmission from mother to child remains one of the most preventable yet persistent gaps in maternal healthcare. Despite significant national progress, delays in antenatal HIV screening still expose thousands of mothers and newborns to avoidable risks.

During a detailed discussion with Dr Pankhuri Gautam, Senior Consultant, Obstetrics & Gynecology at Cocoon Hospital, Jaipur, the specialist highlighted how universal HIV testing in pregnancy has become a cornerstone of safe childbirth.

“Medical science today gives us near-total control over mother-to-child transmission. When interventions begin early, the transmission rate can fall below 2 per cent. The real challenge is the delay in HIV testing, not the lack of treatment,” Dr Gautam explained.

Early Screening: The Most Critical Step

HIV often progresses silently for years, making timely diagnosis vital especially during pregnancy. “Many women are unaware of their HIV status. That’s why testing at the first antenatal visit and again in the third trimester is absolutely critical,” Dr Gautam noted.

Early detection allows doctors to begin antiretroviral therapy (ART) immediately, which rapidly reduces the maternal viral load to undetectable levels. “When the viral load is controlled, women can safely undergo vaginal deliveries without increasing the risk to the infant,” she added.

However, late detection significantly reduces treatment opportunities. Transmission can occur during pregnancy, labour, delivery or even breastfeeding. According to NACO, 25–30% of HIV-positive pregnant women are diagnosed for the first time only during pregnancy, reflecting persistent screening gaps and stigma.

Zero Transmission Is Possible

Dr Gautam emphasised that eliminating mother-to-child HIV transmission (MTCT) is an achievable public health milestone. “Countries in Europe, Africa, and Southeast Asia have demonstrated that near-zero transmission is possible with consistent protocols   universal antenatal testing, early ART, planned delivery methods, infant prophylaxis within 6–12 hours, and clear breastfeeding guidance,” she said.

She added that India already has the clinical capability to replicate these outcomes.

“The capability exists. What we need is universal and timely screening, every single time,” she stressed.

From the first antenatal consultation to postpartum care, early screening helps personalise treatment at every stage. It ensures safe labour planning, timely infant prophylaxis, infection control during delivery, and proper breastfeeding guidance. It also reduces emotional distress for families and enhances long-term ART adherence for mothers.

Protocols Hospitals Must Strengthen

To support India’s goal of eliminating mother-to-child HIV transmission, Dr Gautam outlined key protocols that every maternity centre must prioritise:

• Universal first-trimester HIV screening, regardless of risk factors
  
  

• Repeat HIV testing in the third trimester to detect new infections
  
  

• Immediate ART initiation within 24 hours of diagnosis
  
  

• Delivery planning based on updated maternal viral load levels
  
  

• Infant prophylaxis within 6–12 hours of birth
  
  

• Stigma-free counselling on breastfeeding and postpartum follow-up
  
  

“Hospitals must normalise HIV screening as a standard antenatal procedure, not as a test triggered by suspicion or risk. That shift alone can protect thousands of babies,” Dr Gautam stated.

The Road Ahead

India has made strong progress in HIV management, but preventing mother-to-child transmission requires renewed urgency. With early testing, timely treatment and consistent follow-up, zero transmission is not just a goal it is entirely achievable.

Strengthening antenatal screening today will safeguard the health of mothers, ensure safer deliveries, and give newborns the best possible start to life.