The Hotline is designated by law to receive reports of preliminary positive rapid HIV tests on pregnant people and newborns in labor and delivery units in Illinois. Through real-time reporting, the Hotline can ensure medical consultation to help prevent transmission of HIV. Additionally, the Hotline can dispatch an enhanced case manager to the hospital to provide the patient with support during the time between the preliminary positive test and the confirmatory result. For confirmed positive patients, the enhanced case manager will coordinate all follow-up postpartum HIV care for the birth parent and the exposed infant and address all social service needs.

Your doctor will recommend a regimen of medications that is best for you and your lifestyle. While there are some side effects to the medications, they usually only last for a short time and are well worth the benefit of preventing transmission to your baby! Please tell your doctor about ALL side effects from your medicines and they may be able to help manage those effects for you as well.

Patients should be counseled that positive test results are only preliminary and that additional testing is necessary to confirm the diagnosis. If the patient is at risk for delivery, they should be informed that the second test will likely not be back prior to delivery of their baby. They should be counseled that antiretroviral medication is recommended to reduce the risk of transmission of the virus to the baby. Additionally, they should be counseled to avoid breastfeeding (or pump/store breastmilk in the event of a false positive test) until confirmatory test results are available.

It is imperative that a pregnant person newly diagnosed with HIV meet with an HIV specialist (infectious disease physician) to review their HIV disease. They will draw blood to determine their CD4 (T cells) and viral load. These tests, along with other simple blood tests, will help to determine the recommended course of antiretroviral treatment.

No. Rapid tests cannot be confirmed with another rapid test. It is important to act quickly and obtain a confirmatory test, report the result, and depending on the scenario initiate treatment.

In order to meet state requirements as mandated in the Perinatal HIV Prevention Act, all positive rapid HIV tests on pregnant people in labor and delivery units as well as those performed on newborns must be reported to the Hotline within 12 hours but no later than 24 hours of the test result. Timely reporting allows the Hotline to assist you with medical consultation to help prevent transmission of HIV and to provide linkage to case management to ensure follow-up care.

The best decisions about route of delivery are made together between a patient and their doctor. Certain obstetrical factors about your previous pregnancies and the current pregnancy (non-HIV related) will be weighed in the decision.

No. There should be only one rapid HIV test on the birth parent/newborn pair. If the birth parent declines HIV testing or is missed for HIV testing when pregnant and/or delivering, the newborn must be tested (by law in Illinois). If the newborn’s test is preliminary positive, it means that maternal antibodies to HIV may have been detected in the newborn’s blood. Therefore, it is not necessary to also rapid test the birth parent if the newborn has been tested. A sample may be drawn from the birth parent for confirmatory HIV testing if the newborn's rapid test is preliminary positive.

Many people find out about their HIV status through prenatal testing. HIV and pregnancy can be very isolating, therefore it is important to stress to the patient that they are not alone. Many people become overwhelmed and experience depression when they are first diagnosed. We recommend that you refer patients to a social worker or case manager who specializes in caring for people with HIV. There are many government-sponsored programs for people with HIV who have limited or no resources. An HIV case manager/social worker can help link the patient to an individual counselor or a support group (online or in person). There are trained professionals that can help patients talk about their feelings, talk to partners about the diagnosis, safe sex practices, and dealing with learning about the diagnosis during pregnancy.

Any patient who presents to labor and delivery without prenatal care should be offered and recommended rapid HIV testing. People with a preliminary positive rapid HIV test who are in active labor should be counseled on the test result, the risk of vertical transmission, and the potential benefit of a cesarean delivery in reducing that risk. The patient should receive treatment appropriate for HIV in a laboring patient, until confirmatory tests prove otherwise.

Intravenous Zidovudine (AZT) should be initiated immediately and blood sent for a supplemental HIV test to confirm the positive rapid HIV result. The neonate should also be managed as though the birthing parent is positive until confirmatory tests prove otherwise. See the Illinois Perinatal HIV Hotline’s Best Practices: Labor & Delivery Care for Pregnant People with HIV and Care for Infants with Perinatal Exposure to HIV including those with a positive rapid HIV test.

If the patient is not in labor, and delivery is not imminent, confirmatory testing should be conducted and the patient managed accordingly. Expedited confirmatory HIV testing is available through the Illinois Perinatal HIV Hotline with results generally obtained within 24 hours. Please call 1-800-439-4079 for additional information or specific questions.