16
Patient Management
Special Considerations for Women and the Prevention of
Mother-to-Child Transmission
Contraception and Preconception Care
Î All HIV-infected women of childbearing age should be asked about
their plans and desires regarding pregnancy upon initiation of care
and routinely thereafter (SR-L).
Breast Cancer Screening
Î Mammography should be performed annually in women age >50 years
(SR-H).
Î In women ages 40-49 years, providers should perform individualized
assessment of risk for breast cancer and inform them of the potential
benefits and risks of screening mammography (SR-H).
Menopause
Î Hormone replacement therapy, particularly if prolonged, has
been associated with a small increased risk of breast cancer and
cardiovascular and thromboembolic morbidity, and its routine use is
NOT currently recommended (SR-H).
Î Hormone replacement therapy may be considered in women who
experience severe menopausal symptoms (eg, vasomotor symptoms
and vaginal dryness) but should generally be used only for a limited
period of time and at the lowest effective doses (WR-L).
Mother-to-Child Transmission
Î To prevent infection of their fetus, pregnant women should be treated
for HIV infection, regardless of their immunologic or virologic status
(SR-H).
ÎInfants exposed to HIV in utero should receive antiretroviral postexposure
prophylaxis and undergo HIV virologic diagnostic testing at 14-21 days of
life, at 1-2 months of age, and at 4-6 months of age (SR-H).
Î High-risk exposed infants should have virologic testing at birth (SR-M).
