Letters
Infectious diseases Women's health
Volume 190 - Issue 4

Variable uptake of recommended interventions to reduce mother-to-child transmission of HIV in Australia, 1982–2005

Authors:  Michelle L Giles, Ann M McDonald, Elizabeth J Elliott, John B Ziegler, Margaret E Hellard, Sharon R Lewin and John M Kaldor

Med J Aust 2009; 190 (4): 220-221. || doi: 10.5694/j.1326-5377.2009.tb02359.x
Published online: 16 February 2009
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In reply: We were interested in Gilles and colleagues’ response to our analysis of the uptake of interventions to prevent perinatal HIV transmission in Australia.

As Gilles et al state, the reported rates of perinatal HIV transmission are low in Western Australia, where the choice of delivery modality is individualised. We agree that the additional benefit of elective caesarean section in women being treated with highly active antiretroviral therapy with an undetectable viral load is not known.

We also agree that elective caesarean section is associated with potential risks, and women should have a choice regarding mode of delivery. This choice should be informed by other obstetric factors, maternal viral load, and the clinical setting in which delivery takes place.

Geographic variation in such factors is likely, and will certainly contribute to differences across states in the uptake of preventive interventions. Ongoing national surveillance will help ensure that women with HIV infection and their children benefit as much as possible from evidence-based obstetric practices.

Authors

  • Michelle L Giles1
  • Ann M McDonald2
  • Elizabeth J Elliott3
  • John B Ziegler4
  • Margaret E Hellard5
  • Sharon R Lewin1
  • John M Kaldor2
  • 1. Alfred Hospital, Melbourne, VIC.
  • 2. National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW.
  • 3. Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW.
  • 4. Sydney Children’s Hospital, Sydney, NSW.
  • 5. Centre for Population Health, Burnet Institute, Melbourne, VIC.

Correspondence: m.giles@alfred.org.au

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