Antiretroviral therapy, when taken properly, dramatically lengthens the life spans and improves the physical well being of people living with HIV/AIDS. Although it is true that living longer and healthier lives gives people with HIV more chances of transmitting the virus, antiretroviral therapy also lowers the amount of HIV shed through blood, genital, and anal secretions. With less virus in their body fluids, people with HIV are less likely to transmit HIV (Center for AIDS Prevention Studies, 2003; Vernazza et al, 1999).

Preventing vertical transmission

HIV can be transmitted from an infected mother to her child during pregnancy, labor, delivery, or breastfeeding. Without intervention, the risk of transmission from a mother with HIV to her child before or during birth is 15–25%. Breastfeeding by a mother with HIV raises the risk to a total risk of 20–45% (Newell, 2004). It is very important for pregnant HIV-positive women to discuss prevention options with their healthcare provider.

Postexposure prophylaxis

Postexposure prophylaxis (PEP) is the giving of antiretroviral therapy to people after they have been exposed to HIV, in an attempt to prevent HIV infection. Studies have shown some success with postexposure prophylaxis in the following domains:

Occupational exposure: Among healthcare workers exposed to HIV through needle-stick injuries or other accidental contact with body fluids, those taking antiretroviral postexposure prophylaxis (PEP) were less likely to become infected than were those who did not receive PEP (Cardo et al, 1997)
Nonoccupational exposure: A growing body of evidence suggests that PEP following nonoccupational exposures (including consensual sex, nonconsensual sex, exposure to mother’s body fluids, and injection drug use) may reduce HIV transmission (Roland, 2004)

NIAID makes available PEP guidelines for the treatment of occupational exposure (Panlilio, Cardo, Grohskopf, Heneine, & Ross, 2005) and the treatment of nonoccupational exposure (Smith et al, 2005) to HIV. Unfortunately, antiretroviral therapy often has severe side effects, ranging from fatigue and nausea to diabetes and permanent liver damage. PEP is therefore not a simple "morning-after" approach to HIV prevention (Roland, 2004).

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