ITS BETTER FOR YOUR BABY: North Staffordshire introduces universal testing for HIV for all pregnant women North Staffordshire Health Authority and North Staffordshire Hospital Trust have announced that from the beginning of October all pregnant women will be offered a HIV test as part of their antenatal testing. The test, which is completely safe and free can detect whether the expectant mother has HIV. So far in the UK, over 650 babies have acquired HIV from their mums. The virus can be transmitted from the mother during pregnancy, during labour or via breastfeeding. Now doctors have the ability due to new treatments and drugs to stop the virus from passing to the baby if they know the mother has HIV. The initiative was launched by Charlotte Atkins MP (Staffordshire and Moorlands) at a public health briefing attended by doctors, midwives and HIV health professionals. At the launch, Charlotte Atkins, MP said “Pregnancy is a very emotional time for women, so testing of all kinds is often put to the back of the mind but in my view it is better to be safe than sorry and an HIV test can, if positive, help prevent transmission of HIV from mother to baby”. North Staffordshire is one of the first areas in the UK outside of London to have introduced the testing initiative. Today’s launch follows months of preparation and staff training. Over 60 community midwives have received extensive training to enable them to offer information and support to the 5,500 pregnant women in North Staffordshire each year. Jackie Jenkinson, Community Midwife Team Leader said “This testing initiative is good news for all mums and their babies in the area. Although the chances of a woman having HIV are very low, if she does have the virus, new treatments can help keep the mum healthy and help stop the baby from getting HIV. Community Midwives are used to taking blood to test for a range of conditions so this will be an extra safeguard for the mother and her baby’s health. They have received training on HIV, how it is transmitted and how the new treatments can stop the virus from infecting the baby”. Dr Hilary Thurston, North Staffordshire’s Consultant in Communicable Disease Control and HIV Co-ordinator, said at the launch, “Months of hard work by the district’s Community Midwives have occurred to ensure that all pregnant women benefit from the new opportunities. By working closely with the community midwives we are confident that all pregnant women will receive the information and support they need”. Since 1985, over 650 babies in the UK have become infected with HIV as a result of transmission from their mother. HIV can be passed to the baby during pregnancy (where HIV crosses the placenta), at the time of labour (where trauma and blood create conditions where the baby can be infected) and after birth (where the baby can be infected through breastfeeding). If a woman has HIV the chances of her baby acquiring the virus range from 15% (if she bottles feeds) to 30% (if she breastfeeds). Since the late nineties a range of drugs (“combination therapy”) have been made available (nationally and in North Staffordshire) which have radically changed and improved the treatment of HIV disease. If a woman knows she has HIV, certain interventions can be undertaken to reduce mother to baby transmission: AZT (an antiviral drug) therapy can be given to the mother from the second term of pregnancy, AZT can be administered intravenously during labour, a minimal blood loss caesarean can be performed, and the new born infant can be given an anti viral syrup in the first few weeks of life. This reduces the chances of the baby getting HIV from 30% to less than 2% - but only if the mother knows she has HIV. More than 70% of pregnant women with HIV in the UK are unaware that they have the virus. Thus the intervention to test all pregnant women in the UK as part of their normal antenatal blood tests (e.g. rubella, hepatitis, syphilis, antibodies). By testing all women, pregnant mothers will be able to know their HIV status and receive treatment to minimise the chances of their baby becoming infected. They will also be able to benefit from the new drugs to help maintain their own health. The testing initiative is cost-effective. In North Staffordshire, this initiative has been warmly welcomed by health professionals, women and HIV service user representatives. The initiative has been led by the community midwives of North Staffordshire Hospital Trust, supported by the HIV team at North Staffordshire Health Authority. Over 60 midwives have received two half day training seminars, a further ten have been involved in two days training. From this the community midwives have helped developed the thinking, policy and implementation of the initiative. In North Staffordshire, the initiative is woman focussed and community midwife led. The testing is voluntary and whatever a woman chooses to do, the quality of her care will not be affected. A major information campaign will be undertaken in North Staffordshire to tell woman of the new testing arrangements, and the choices now available. It is the hope of all involved, as professional health care workers, HIV positive people, volunteers, pregnant women, that in the future no baby acquires HIV. Niall McGrogan