Experts call for continued focus on the impact of HIV on women and babies
London, UK – 27 November 2015 More than 5,000 babies across the UK have avoided being born with HIV in the last 15 years, because of the care received by their mothers before, during and after childbirth, according to figures announced today by the British HIV Association (BHIVA). About 15,000 infants were born to women with HIV in the UK between 2000 and 2014 and without proper care, about one in three births to HIV-infected women would have resulted in an infant with HIV.
A combination of routine HIV testing in pregnancy, antiretroviral medication, high quality care during delivery and avoiding breastfeeding can reduce the risk of HIV passing from mother to child to around one in 1,000. Preventing infection allows women with HIV to have a family with confidence and gives their babies the best start in life. In addition the costs associated with the lifetime care of babies born with HIV are avoided. Conservative estimates based on the lifetime costs of HIV-related care and treatment suggest that since 2000, the UK's highly successful programme of preventative care has not only saved many children's lives, but also saved the NHS £3.1 billion.
Speaking at the BHIVA Prevention of Perinatal HIV Infection conference in London on 27 November, Dr Annemiek de Ruiter, of Guy's and St Thomas' NHS Foundation Trust and Chair of the BHIVA Guidelines for the Management of HIV in Pregnancy, said: "The UK is a world leader in this field, successfully preventing HIV infection in 99.5% of babies born to women with HIV and giving thousands of young people the chance to live free from a stigmatizing condition that requires daily treatment and regular contact with health services. To maintain – and even improve upon – these rates of prevention, we need to invest in what we know works. HIV testing and support for women with HIV, their partners and families must continue as a top priority for national and local government."
Angelina Namiba, a Project Manager from London who has HIV, and who gave birth to her HIV-free daughter in 1998, said: "When I was first diagnosed with HIV in my early 20s, I could barely imagine living to 30. My dreams of having children vanished. But I was lucky; I found an excellent peer support group and learned that with the right clinical care and support, it was possible to start a family with very low risk of my partner or baby becoming infected. To have been able to have a child without HIV and watch her grow still feels almost unbelievable to me. I am grateful every day – but without peer support at an early stage, my daughter and I probably wouldn't be here."
The conference theme – 'Aiming for Zero' – signifies the widely held hope that the transmission of HIV from mothers to their babies can be eliminated in the near future. Experts believe this may be possible, providing all mothers-to-be with HIV are aware of their infection and are able to access the specialized care and support they need. This includes appropriate antiretroviral therapy, the right mode of delivery, antiretroviral treatment for new born babies and the avoidance of breastfeeding, alongside peer support and social care. Reaching out to men to test for HIV is a further crucial intervention, helping to ensure that women avoid becoming infected with HIV whilst pregnant and breastfeeding.
To reach the goal of zero transmission, experts at the conference will call for
Continued access to world class, widely available open access HIV testing, treatment and care which is free of charge
Continued provision of coordinated care between providers of women’s services, HIV services and paediatric services
Resources for peer mentoring and peer support that maximize the health and wellbeing of women with HIV, particularly during pregnancy and after birth
Programmes to reduce HIV-associated stigma so that women with HIV are better able to talk about their condition and access the services they need
Enhanced HIV testing programmes that reach the male partners of pregnant women, to reduce the risk of women acquiring HIV
Resources to deliver simple and cheap interventions such as free replacement feeding equipment and formula
In 2011 (the last year for which published data is available), the estimated HIV prevalence in pregnant women in England was 2.2 per 1,000. This was highest in London with 3.5 per 1,000. HIV prevalence was highest among sub-Saharan African-born pregnant women with 23 per 1,000. This compares to an HIV prevalence of 0.5 per 1,000 among UK-born pregnant women.
Dr de Ruiter continued: "If we are to get even closer to zero rates of mother-to-child infection, HIV must be prioritised by the UK's health services. We must continue to test early for HIV in pregnancy, provide appropriate support and tackle the continuing challenges faced by women who are living with HIV in the UK."
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Jon Cope: 07867 508212
Founded in 1995, BHIVA is the leading professional organisation committed to providing excellence in the care of those living with and affected by HIV. It acts as a national advisory body to professions and other organisations on all aspects of HIV care. BHIVA also provides a national platform for HIV care and contributes representatives for international, national and local committees dealing with HIV care. In addition, BHIVA works to promote undergraduate, postgraduate and continuing medical education within HIV care. Visit www.bhiva.org for more information about BHIVA, and follow us on Twitter @BritishHIVAssoc
Notes for editors
The estimated cost saving of £3.1 billion to the NHS in the UK is based on the following calculation:
Estimated number of babies likely to have been born with HIV if interventions to prevent HIV transmission were not in place = 5,056 *multiplied by estimated cost per person of HIV treatment and care from birth to age 71 = £622,800 (est.)**
* Of the 15,520 births to mothers with HIV in the UK and Ireland between 2000 and 2015, it is estimated that one in three (5,056) would have resulted in an infant with HIV, with no interventions to prevent perinatal HIV transmission.
**Estimated healthcare cost for a male with HIV from age 30 to death at 71 = £360,000 at current prices.i Figure of £360,000 multiplied by 1.73 to account for costs of care and treatment from birth to age 30 = £622,800
i Nagakawa, F, Miners, A, et al. Projected Lifetime Healthcare Costs Associated with HIV Infection. PLoS ONE 10(4): e0125018. doi:10.1371/journal.pone.0125018