Which strategy is recommended for delivery in an HIV-positive patient with a viral load greater than 1000 copies/mL?

For an HIV-positive patient with a viral load greater than 1000 copies/mL, the recommended strategy for delivery is an elective cesarean section. This approach is based on the risk of perinatal transmission of HIV during vaginal delivery. When the viral load is above 1000 copies/mL, the chances of transmitting the virus to the infant during the delivery process are significantly increased because the virus may be present in the amniotic fluid and maternal blood during labor.

An elective cesarean section performed when the mother is not in labor reduces the risk of exposure to the virus for the infant. This intervention is an essential part of an HIV management strategy during pregnancy to protect the newborn from HIV transmission. In contrast, vaginal delivery carries the potential risk of the infant coming into contact with the virus during passage through the birth canal, which could result in transmission of the virus.

Therefore, when the viral load is higher than the specified threshold, the recommendation for an elective cesarean section serves to minimize the risks associated with delivery while promoting the best outcome for both mother and child.