Mother-to-child transmission of HIV in Australia and other high-income countries: trends in perinatal exposure, demography and uptake of prevention strategies

O'Donovan, Kelly, and Emeto, Theophilus I. (2018) Mother-to-child transmission of HIV in Australia and other high-income countries: trends in perinatal exposure, demography and uptake of prevention strategies. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58 (5). pp. 499-505.

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Abstract

Virtual elimination of mother-to-child transmission (MTCT) of HIV is a global target. A review of the literature was conducted using medical databases and health department websites to examine the current trends related to perinatal HIV exposure and MTCT in Australia in comparison to other high-income countries (HICs). It discusses the uptake of prevention strategies and barriers that impede MTCT prevention. The literature suggests an increase in the numbers of HIV-exposed deliveries, but a marked decline in the rates of MTCT within HICs. MTCT remains high when the mothers’ HIV infection is diagnosed late or postpartum. Data supports increasing trends of perinatal HIV exposure in migrant populations from low and middle-income countries (particularly African women). Increased uptake and earlier initiation of antiretroviral therapy (ART) was associated with overall MTCT decline. Caesarean Section remains the main mode of delivery described; however, the numbers of planned vaginal deliveries are increasing over time. Heterogeneity of data periods and outcome measures within published literature made comparisons between countries difficult. Future development should focus on clear national guidelines and a potential national database for perinatal HIV, culturally appropriate service provision, and more evidence on acute infections in pregnancy and the effects that longer duration and increased uptake of ART has on the fetus and resistance to ART.

Item ID: 53074
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: Australia; high-income; HIV; mother-to-child transmission; perinatal
Date Deposited: 06 Jun 2018 23:05
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111712 Health Promotion @ 30%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 50%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 50%
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