Uptake of interventions to reduce mother-to-child transmission of HIV in the United Kingdom and Ireland.
OBJECTIVE
To describe the uptake of interventions to reduce mother-to-child transmission of HIV infection.


METHODS
Voluntary confidential reporting of HIV infection in pregnancy and childhood; telephone interview with key professionals in all London maternity units.


METHODS
HIV-infected pregnant women and children in the United Kingdom and Ireland.


METHODS
Trends in breastfeeding, use of zidovudine, mode of delivery and terminations of pregnancy.


RESULTS
Between 1990 and 1995, 14 (4%) out of 314 women diagnosed with HIV infection before delivery breastfed compared with 109 (77%) out of 142 diagnosed after delivery. Since 1994, zidovudine use has increased in each 6-month period (14, 39, 67, and 75%; chi 2 = 17.5, P < 0.001), although in 1995 it was the policy of only 48% of London maternity units to offer zidovudine to HIV-infected women. During 1995, 44% of HIV-infected women were delivered by elective Cesarean section. Since 1990, 20% of women first diagnosed in pregnancy were reported to have their pregnancy terminated.


CONCLUSIONS
Although detection of previously undiagnosed HIV infection in pregnancy remains low in the United Kingdom, and particularly in London, HIV-infected pregnant women who are aware of their status are increasingly active in taking up interventions to reduce transmission to their infants. If all HIV-infected women attending for antenatal care in London consented to testing and took up interventions and termination of pregnancy at the rates observed in this study, the number of vertically infected babies born in London each year could be reduced from an estimated 41 to 13.
Gibb
D M
DM
Department of Epidemiology and Biostatistics, Institute of Child Health, London, UK.
MacDonagh
S E
SE
Tookey
P A
PA
Duong
T
T
Nicoll
A
A
Goldberg
D J
DJ
Hudson
C N
CN
Peckham
C S
CS
Ades
A E
AE
D000028:Abortion, Induced; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding; D002585:Cesarean Section; D036861:Delivery, Obstetric; D004363:Drug Utilization; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007494:Ireland / Q000453:epidemiology; D008427:Maternal Health Services; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D006113:United Kingdom / Q000453:epidemiology; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine