Treatment of human immunodeficiency virus during pregnancy: The shift froman exclusive focus on fetal protection to a more balanced approach

A review is presented of policy and treatment guidelines for human immunode ficiency virus infection in pregnancy. Interventions that serve the best in terests of pregnant women and their fetuses are suggested. Reproductive stu dies with animals should be done routinely, and more research with pregnant women should be conducted. Women and their health care providers need to s hift away from the "therapeutic nihilism" paradigm. All clinical decisions must be made cautiously and thoughtfully, with the understanding that the h ealth needs of the pregnant woman are usually whatever is in the best inter est of the developing fetus.