Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1

Read, Jennifer S.; Newell, Marie‐Louise

doi:10.1002/14651858.cd005479

Cited by 110 publications

(110 citation statements)

References 31 publications

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“…Findings from a systematic review conducted by Read and Newell (27) suggest that Elective Cesarean Section (ECS) is an efficacious method in terms of PMTCT of HIV (27). Considering the above-mentioned systematic review, proper interventions are warranted to address stigmatizing and discriminatory attitude of Iranian physicians, and consequently to prevent MTCT of HIV through safe cesarean.…”

Section: Unintended Pregnancy and Safe Abortion Servicesmentioning

confidence: 99%

Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study

Moazen

Rezaei

Hajizadeh

et al. 2015

Int J Health Policy Manag

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Background: People Living with HIV (PLHIV) are highly stigmatized and consequently hard-to-access by researchers and importantly, public health outreach in Iran, possibly due to the existing socio-cultural situation in this country. The present study aimed to evaluate the sexual and reproductive health needs of PLHIV in Tehran, the capital of Iran. Methods: As a mixed-method descriptive study, this project was conducted in 2012 in Tehran, Iran. In this study, we evaluated and discussed socio-demographic characteristics, family and social support, sexual behaviors, fertility desires and needs, PMTCT services, contraceptive methods, unintended pregnancy and safe abortion, and Pap smear tests among 400 participants referring to the behavioral disorders consulting centers. Results: Of the sample 240 (60%) were male and 160 (40%) were female. About 50% of women and 40% of men were 25-34 years old. More than 60% of men and 96% of women were married, while more than 50% of the participants had HIV-positive spouses at the time of study. According to the results, fertility desire was observed among more than 30% of female and 40% of male participants. Results of the in-depth interviews indicate that the participants are not satisfied with most of the existing services offered to address their sexual and reproductive health needs.

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Section: Unintended Pregnancy and Safe Abortion Servicesmentioning

confidence: 99%

Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study

Moazen

Rezaei

Hajizadeh

et al. 2015

Int J Health Policy Manag

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“…148,152,155 In some settings, elective delivery by caesarean section can further reduce HIV-1 transmission during the intrapartum period, but the benefits of the intervention could be countered by post-partum sepsis and increasing maternal mortality. 156 Because HIV-1 can be transmitted by breastfeeding, replacement feeding is recommended in many settings. Poor access to clean running water precludes, however, the use of formula feeding under these circumstances, 157 and exclusive breastfeeding with abrupt weaning is one option for reducing transmission.…”

Section: Mother-to-child Transmissionmentioning

confidence: 99%

HIV/AIDS epidemiology, pathogenesis, prevention, and treatment

2006

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The HIV-1 pandemic is a complex mix of diverse epidemics within and between countries and regions of the world, and is undoubtedly the defining public-health crisis of our time. Research has deepened our understanding of how the virus replicates, manipulates, and hides in an infected person. Although our understanding of pathogenesis and transmission dynamics has become more nuanced and prevention options have expanded, a cure or protective vaccine remains elusive. Antiretroviral treatment has transformed AIDS from an inevitably fatal condition to a chronic, manageable disease in some settings. This transformation has yet to be realised in those parts of the world that continue to bear a disproportionate burden of new HIV-1 infections and are most a % ected by increasing morbidity and mortality. This Seminar provides an update on epidemiology, pathogenesis, treatment, and prevention interventions pertinent to HIV-1. HIV pandemicAn estimated 38·6 (33·4-46·0) million people live with HIV-1 worldwide, while about 25 million have died already. 1 In 2005 alone, there were 4·1 million new HIV-1 infections and 2·8 million AIDS deaths. 1 These estimates mask the dynamic nature of this evolving epidemic in relation to temporal changes, geographic distribution, magnitude, viral diversity, and mode of transmission. Today, there is no region of the world untouched by this pandemic (figure 1). 2 Heterosexual transmission remains the dominant mode of transmission and accounts for about 85% of all HIV-1 infections. Southern Africa remains the epicentre of the pandemic and continues to have high rates of new HIV-1 infections. 3 Although overall HIV-1 prevalence remains low in the emerging epidemics in China and India, the absolute numbers, which are fast approaching those seen in southern Africa, are of concern. 1 Outside of sub-Saharan Africa, a third of all HIV-1 infections are acquired through injecting drug use, most (an estimated 8·8 million) of which are in eastern Europe and central and southeast Asia. 1 The rapid spread of HIV-1 in these regions through injecting drug use is of importance, since it is a bridge for rapid establishment of more generalised epidemics. NIH-PA Author ManuscriptA defining feature of the pandemic in the current decade is the increasing burden of HIV-1 infections in women, 4 which has additional implications for mother-to-child transmission. Women now make up about 42% of those infected worldwide; over 70% of whom live in sub-Saharan Africa. 1 Overall, a quarter of all new HIV-1 infections are in adults aged younger than 25 years. 1 HIV-1 infection rates are three to six times higher in female adolescents than in their male counterparts, 1,5-7 and this difference is attributed to sexual coupling patterns of young women with older men. Population prevalence of HIV-1 infection, concurrent sexual relationships, partner change, sexual practices, the presence of other sexually transmitted diseases, [8][9][10][11] and population mobility patterns 12-14 for economic and other reasons (eg, natu...

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“…In Australia, universal screening for syphilis is recommended in pregnancy, with a treponemal-specific serological assay performed at the first antenatal visit, and repeat screening in high-risk populations should be considered at 28 weeks 10,11 . Modalities available for diagnosing congenital syphilis in Australia include both treponemalspecific and non-treponemal specific serology, nucleic acid detection, direct fluorescent antibody testing, and histochemical staining (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Under the Microscope Historically, elective Caesarean section was recommended as an intervention to reduce perinatal transmission, although the data to support this were primarily before the advent of combination therapy with more recent analyses suggesting the risk of perinatal HIV transmission is comparable in women with an undetectable viral load 10,11 . Today, vaginal birth is the recommended mode of delivery in women with an undetectable viral load (defined as either <50 copies/mL in guidelines from the United Kingdom to <1000 copies/ mL in guidelines from the United States) 12,13 unless there is an obstetric indication for a Caesarean section.…”

Section: Management During Pregnancymentioning

confidence: 99%

HIV in pregnant women and prevention of perinatal transmission

Giles¹

2015

Microbiol. Aust.

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Women with HIV who have access to treatment can expect to have a normal life expectancy. With effective antiretroviral therapy, an undetectable viral load, and avoidance of breastfeeding, the rate of perinatal transmission is extremely low (<1%). A Caesarean section is no longer routinely recommended nor is intrapartum zidovudine. Women living with HIV should be supported in their decision regarding parenthood given their excellent prognosis, low risk of perinatal transmission and reproductive rights. If interventions to reduce perinatal HIV transmission during pregnancy and post-partum are embraced, women can expect to have an uninfected infant.

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Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1

Cited by 110 publications

References 31 publications

Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study

Sexual and reproductive health needs of HIV-positive people in Tehran, Iran: a mixed-method descriptive study

HIV/AIDS epidemiology, pathogenesis, prevention, and treatment

HIV in pregnant women and prevention of perinatal transmission

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