A 32-year-old pregnant woman at 36 weeks of gestation attends her routine prenatal visit. She was diagnosed with HIV during her first trimester and initiated on antiretroviral therapy (ART) with a combination of tenofovir, emtricitabine, and dolutegravir. Her prenatal course has been uneventful. There is no evidence of opportunistic infections or pregnancy-related complications. In which scenario is a cesarean delivery most strongly recommended for an HIV-positive mother to reduce the risk of mother-to-child transmission?
