To the Editor: We read with interest Giles and colleagues’ recent article, which examined the adoption of strategies to reduce perinatal transmission of HIV infection in Australia.1 They found that uptake of strategies to reduce perinatal HIV transmission had increased, with widespread use of antiretroviral therapy (ART) and breastfeeding avoidance. The authors also noted that caesarean birth was a strategy less commonly utilised by women with HIV infection. They made particular comment about the caesarean delivery rate for women known to have HIV infection in Western Australia. It was disappointing that the authors did not refer to our recent publication describing the low rate of perinatal HIV transmission in WA using an individualised delivery modality policy.2
- 1. Giles ML, McDonald AM, Elliott EJ, et al. Variable uptake of recommended interventions to reduce mother-to-child transmission of HIV in Australia, 1982–2005. Med J Aust 2008; 189: 151-154. <eMJA full text> <MJA full text>
- 2. Gilles MT, Dickinson JE, Cain A, et al. Perinatal HIV transmission and pregnancy outcomes in Indigenous women in Western Australia. Aust N Z J Obstet Gynaecol 2007; 47: 362-367.
- 3. Branson BM, Handsfield HH, Lampe MA, et al; Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep 2006; 55 (RR-14): 1-17.
- 4. Townsend CL, Cortina-Borja M, Peckham CS, Tookey PA. Trends in management and outcome of pregnancies in HIV-infected women in the UK and Ireland, 1990–2006. BJOG 2008; 115: 1078-1086.
- 5. Suy A, Hernandez S, Thorne C, et al. Current guidelines on management of HIV-infected pregnant women: impact on mode of delivery. Eur J Obstet Gynecol Reprod Biol 2008; 139: 127-132.
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