Why an HIV Test May Come Back Falsely Positive During Pregnancy

During pregnancy, getting tested for HIV regularly has become the norm these days, which raises the stakes for getting a false positive result. Learn why HIV tests may come back falsely positive during pregnancy, with fascinating explanations provided by experts.

The extensive testing and blood work required throughout pregnancy can be a very stressful part of growing a human over the course of nine months. Even though some tests and labs are required for the course, they still have the potential to produce unexpectedly nerve-wracking moments. In the most recent thread on the Baby Bumps subreddit, an expectant mother shared that she had recently been dealing with this very issue, as she had recently received what she believed to be a false positive result on her routine first-trimester HIV test.

One user on Reddit receives unexpected test results.

The initial poster abbreviated OP, wrote, “After having blood work done during the first trimester to confirm pregnancy, etc., the previous week, I received a voice message from my doctor asking me to make an urgent appointment as soon as possible. Today, she tells me I need to come in because one of the tests returned positive for HIV. I simply cannot believe what I’m hearing or seeing at this point. She reassured me that it was probably just other antibodies reacting to the test but that in order to confirm this, I would need to have additional blood work done.”

The original poster (OP) mentioned that she had observed other users of the subreddit receiving false positives, which is why she wished to share her experience with the community at large.

Is It Possible That Being Pregnant Could Give a False Positive Result for HIV?

Is it possible, then, that being pregnant could result in a false positive HIV test? Not quite, but there have been instances of false positives. The fact that pregnant women are tested twice as frequently as the general population may cause them to have a higher chance of receiving a false positive result, according to experts.

The Centers for Disease Control and Prevention report that false-positive test results are less than 2% of the time, despite the fact that these results are extremely rare (CDC). False positives are experienced more frequently in pregnant people, but this can vary depending on the type of test.

According to Felice Gersh, M.D., OB-GYN, author of PCOS SOS Fertility Fast Track, the HIV screening test that is currently in use is not always accurate. The screening test that was utilized measures antibodies; however, there is a possibility that other substances in the woman’s body will react, which will result in a false-positive test. When a pregnant woman has a positive result on a screening test, a different type of test called a Western blot (WB) is performed as a confirmatory test.

The following is a list of potential causes of a false positive result:

According to Dr. Lipeles, the following scenarios, viruses, and conditions are thought to increase the likelihood of a false-positive HIV test result:

• Provision of the vaccination against influenza (the CDC recommends that all pregnant people get the vaccine).
• Antibodies against HLA-DR are present in women who have previously carried a pregnancy to term.
• Rheumatoid factor was found to be present.
• The RPR came back positive (screening for syphilis).
• Hypergammaglobulinemia refers to an increase in the amount of antibodies present in the blood and may be the result of multiple myeloma or an infection.
• Autoimmune hepatitis.

Dr. Lipeles notes that additional research is currently being conducted to determine whether or not there is a pregnancy-specific factor that may have the potential to increase the incidence of false-positive HIV tests. This is very encouraging to hear, especially because, as other researchers have pointed out, pregnant people should be subjected to as little unnecessary stress as possible.

The Experience of One Reddit User Illustrates Why False Positives Can Be Stressful

The original poster of the Reddit thread serves as an excellent illustration of the anxiety that can be brought on by a false-positive test result. She stated that her physician had reassured her that HIV is a disease that can be managed, that life expectancy is high with the appropriate medication, and that the risk of transmitting the disease to the baby was extremely low to none when taking into account the medications. On the other hand, the woman who was expecting a child wrote that she “just nodded along in shock because I couldn’t process what she was saying.”

Other users on Reddit brought up the point that the stigma associated with HIV is an important consideration for the original poster to take into account. One person remarked that “HIV carries such a huge” (and in modern times, completely undeserved) stigma. “My point is that if it is in the positive direction, it is not because of anything you did. This is something that is obvious to anyone who has even the most basic knowledge of the virus, and it reveals absolutely nothing about who you are as a person.”

Another user on Reddit, who called herself an HIV test counselor, offered reassurance by writing, “Your doctor has made all of the points that I was going to make. But I’ll say it again: A blood test will be able to confirm that it was just a false positive. HIV is not the same as AIDS, and most people with health insurance in the West will not get AIDS even if they have HIV. It is a chronic condition that can be controlled, however.”

People who follow the current recommended protocol of combination antiretroviral drugs have been shown to have an additional life expectancy of nearly 55 years, according to research that was just recently conducted and published in the journal AIDS.

Thankfully, the test turned out to be a false positive in the end.

OP recently shared her follow-up test results, which were negative, just as she had suspected. However, here’s hoping that by sharing her common experience, the OP was able to educate more expectant parents about HIV and the prevalence of false positives when you’re pregnant.

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