I was two months pregnant with my first child when I tested HIV-positive. I terminated the baby. Neither my husband nor I ever had sex outside our seven-year relationship. How could we possibly get this disease? I did an HIV test over a year ago, and it was negative. Can someone have it for years, and then have it show up on a test? Is there another way you can get HIV besides sex? How about sharing another person's drink, taking birth control shots, or going to the dentist? How can we have a normal life now? We could never have any children, because the child might become infected. We live on an island near the Bahamas, about 45 minutes from Miami.

Marie

There are several important issues regarding your case. First and foremost is the following: Do you actually have HIV? As I have written before, the primary test for determining whether one is infected with HIV (the virus that causes AIDS) is an antibody test. When someone is infected with HIV, the body makes antibodies (disease-fighting proteins) directed against HIV. These antibodies are detected by a highly sensitive HIV test called the ELISA test. Very few HIV-infected people test negative to this test (meaning that the test does not find evidence of infection in someone who does have HIV), although some people who are not infected still test positive. To confirm the results of a positive ELISA test, a Western blot, a more accurate antibody test, is done. False positive Western blot tests are very rare.

I would not trust your HIV diagnosis unless you had the Western blot test. In most of the United States, both tests are required. Where you live, perhaps they only did the ELISA test. If this is the case, then you definitely need to confirm your diagnosis with a Western blot. Also, if you truly had a negative test a year or so ago and have not had any possible exposures to HIV since then, then you should have another Western blot, even if the first one was positive. Perhaps a mistake occurred in the lab.

If the first test was falsely negative and you are indeed HIV-positive, then you may have been infected during the past year or much earlier. You may have caught the virus from your husband, who could have carried it for years without knowing. He should definitely be tested. Contracting HIV infection from routine household contact, such as sharing drinking glasses or toilet seats, is not likely at all. Sex and contact with contaminated blood are the primary means of transmission.

What about the other possible sources of infection you mentioned? In the United States, shots (such as those for birth control) pose essentially zero risk of HIV. The needles should be sterile and the medication itself will certainly be free of the virus. If you are concerned that you might not be getting a sterile needle, you can ask the nurse to let you watch her or him take it out of the sterile packaging. (I have asked that of a nurse for my son.) It is theoretically possible for HIV to be passed from a dentist to a patient, and this kind of transmission was shown to have occurred at least once. But the risk is very low, and I highly doubt that is how you contracted HIV.

Although most HIV-positive people are carriers of the virus for years before they become ill, their HIV tests will be positive within a few months after infection, even when they have no symptoms. Therefore, unless your test more than a year ago was a rare false negative, if you turn out to be HIV-positive, you were infected recently. If a repeat Western blot test indicates that you are HIV-positive, you should have a thorough evaluation, including testing of your viral load (the amount of virus in the blood). If you have detectable virus in the blood, especially high levels of virus, then you should have anti-HIV treatment, the so-called drug cocktail (a combination of anti-HIV drugs). These medications are expensive, but there are some places in the United States where treatment is free, even for people who lack health insurance. I have no idea whether such treatment centers are available in your area.

I would like to make one final point. If you are actually HIV-positive, that does not mean that you can never safely have children. If AZT (zidovudine, or Retrovir) is given to a pregnant woman with HIV before and during delivery and to the baby for six weeks after birth, the rate of transmission to the baby is less than 10 percent -- less than 5 percent in some studies.