Don't Get Stuck With HIV

Protect yourself from HIV during healthcare and cosmetic services

Patient observed sterile treatment for antenatal care

POST for antenatal care: Antenatal clinics commonly give women one or more tetanus vaccinations so their babies don’t get tetanus, and take venous blood to test for syphilis and/or anaemia.
1. Avoid skin-piercing procedures (a) If a high percentage of adults in your community have HIV, consider going to a private provider for antenatal care. If so, choose a provider who will listen to your concerns, and will show you that what he or she does is safe.(b) Ask your provider if you can avoid tests taking venous blood. If a test is important, ask if it can be done some other way, such as with urine or finger prick blood.
2. Use new disposable instruments (a) Bring new disposable syringes and needles for all injections and blood tests (see Injections section).(b) Take tetanus vaccine from a single-dose vial, or from a multi-dose vial opened for you (see Injections section). If you get more than one dose of tetanus vaccine during repeated antenatal visits, open a new vial each time. The vaccine saved in an opened vial can grow a lot of pathogens (germs) and can be very dangerous.
3. You sterilize the instruments Not applicable. Use new disposables for everything.
4. Ask providers how they sterilize instruments Not applicable. Use new disposables for everything.

Additional information about antenatal care

Vaginal exams: See Birth control and other women’s health care section.

At the clinic you visit, how many women are HIV-positive? The risk to get HIV during antenatal care depends on how many women in the clinic have HIV. In Southern Africa, you should estimate that 1 or 2 among the 5 women treated before you have HIV infections. In Eastern Africa, you can estimate that 1 or 2 among the 10 women before you have HIV.

Risk to get HIV from antenatal care

If a previous patient is HIV-positive, and a provider reuses syringes and/or needles without any effort to clean to give you tetanus injections or to take blood from a vein, and if the provider takes tetanus vaccine from an opened multi-dose vial, your risk to get HIV may be estimated at 3%-10% for each tetanus injection and blood test (see Table on Estimated risks in Blood-borne Risks section).

If the provider uses new syringes and needles and opens a new vial of vaccine for each injection, you have no risk to get HIV from these procedures.

Evidence that procedures during antenatal care have infected women with HIV

Antenatal clinics commonly give women tetanus vaccinations to prevent neo-natal tetanus, and take venous blood to test for syphilis and/or anaemia. Data from national surveys in 11 African countries suggest that many women may have gotten HIV infections from antenatal care (see Table). Among women who gave birth in the last 5 years, women were more likely to be HIV-positive if they had received tetanus vaccinations and/or had given blood for tests during antenatal care, compared to women who did not have these risks.

Table: Evidence that women* got HIV from antenatal care

Risk, country, year Relative risk to be HIV-positive among women with vs. without the specified procedure during antenatal care
Tetanus vaccinations
Kenya, 2003 Several estimates[i][ii][iii][iv][v] range from: 1.27 to 1.92
Burkina Faso, 2003 2 estimates[vi][vii] range from 1.26 to 1.77
Cameroon, 2004 2 estimates[viii][ix] range from 1.53 to 2.06
Ethiopia, 2005; Ghana, 2003; Lesotho, 2004; Senegal, 2005 Estimates[x] for 4 countries range from: 0.63 to 7.60
Cameroon, 2004; Ethiopia 2005; Ghana, 2003; Guinea, 2005; Kenya, 2003; Lesotho, 2004; Senegal 2005; Malawi, 2004; Rwanda, 2005; Zimbabwe, 2005-06 Composite estimate[xi] for 10 countries: 1.19
Giving blood for tests
10 countries listed above Composite estimate[xii] for 11 countries: 1.23
Tetanus vaccinations and/or giving blood for tests
10 countries listed above Composite estimate[xiii] for 10 countries: 1.28

* These results are for women who gave birth in the last 5 years.


[i] Deuchert E, Brody S. The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya. Int J STD AIDS 2006; 17: 749-752.

[ii] Schmid G, Khamassi S, Cherian T. The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya. Int J STD AIDS 2007; 18: 145.

[iii] Deuchert E, Brody S. The evidence for health-care transmission of HIV in Africa should determine prevention priorities. Int J STD AIDS 2007; 18: 290-291.

[iv] Marum L, Bennett E, Hightower A, Chen R, Kaiser R, Olello D, Mermin J, Sharif SK. The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya. Int J STD AIDS 2009; 20: 69-70.

[v] de Walque D. Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries. Sex Transm Infect 2008; 84: 122-125.

[vi] Deuchert E. Maternal healthcare and the spread of AIDS in Burkina Faso and Cameroon. World Health Popul 2007; 9: 55-72.

[vii] de Walque D. Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries. Sex Transm Infect 2008; 84: 122-125.

[viii] Deuchert E. Maternal healthcare and the spread of AIDS in Burkina Faso and Cameroon. World Health Popul 2007; 9: 55-72.

[ix] de Walque D. Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries. Sex Transm Infect 2008; 84: 122-125.

[x] de Walque D. Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries. Sex Transm Infect 2008; 84: 122-125.

[xi] Brewer DD, Roberts JM, Potterat JJ. Punctures during prenatal care associated with prevalent HIV infection in sub-Saharan African women. International Society for Sexually Transmitted Diseases Research, Seattle 2007.

[xii] Brewer DD, Roberts JM, Potterat JJ. Punctures during prenatal care associated with prevalent HIV infection in sub-Saharan African women. International Society for Sexually Transmitted Diseases Research, Seattle 2007.

[xiii] Brewer DD, Roberts JM, Potterat JJ. Punctures during prenatal care associated with prevalent HIV infection in sub-Saharan African women. International Society for Sexually Transmitted Diseases Research, Seattle 2007.

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