North American Registry of Midwives (NARM) Practice Exam

What is the risk of perinatal HIV transmission without any antiretroviral treatment?

1. 5%

2. 15%

3. 25%

4. 35%

The correct answer is: 25%

Perinatal HIV transmission refers to the transmission of the HIV virus from an HIV-positive mother to her child during pregnancy, labor, delivery, or breastfeeding. Without any antiretroviral treatment (ART), the risk of transmitting HIV from an infected mother to her infant is significantly elevated. Research indicates that, in the absence of any preventive measures, including antiretroviral therapy, the risk of perinatal transmission can be as high as 25% to 35%. Specifically, the 25% figure is often cited as a baseline risk when considering mothers who are not receiving treatment. If we also consider various factors such as the stage of HIV infection, the mode of delivery, and whether the mother is breastfeeding, the risk can increase even further. In contrast, the figures suggested in the other choices are lower than the established risk associated with untreated HIV. With current guidelines and aggressively treating HIV with ART during pregnancy, perinatal transmission rates can drop to below 1%. However, in an untreated context, the 25% risk is consistent with established medical literature and reflects the serious implications of unmanaged HIV in expectant mothers.