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HIV is transmitted from person to person via bodily fluids, including blood, semen, vaginal discharge, and breast milk. An HIV–infected woman can pass the virus to her baby during pregnancy, labor, delivery, or breastfeeding. The higher the viral loads (level of HIV in the blood), the more likely the mother will infect her baby. HIV patients who are otherwise healthy and receiving antiretroviral therapy (ART) usually have about 200–500 copies per milliliter of blood. A high viral load can be anywhere from 5,000 to one million or more copies. A high viral load indicates that HIV is replicating and the disease will most likely progress quicker than if the viral load is low. However, no viral load is low enough to completely eliminate the risk of transmission. Even if the viral load is undetectable, the virus may still be transmitted. While transmission of infection from mother to baby may occur at any time, it usually happens just before or during delivery, when the baby is exposed to the mother's blood and vaginal secretions. If the vaginal delivery is prolonged, the baby is more likely to become infected because the newborn is exposed to these fluids for a longer period of time.
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