Our antenatal service for people living with HIV

For World AIDS Day, consultant in HIV and genitourinary medicine Dr Rebecca Simons has written a blog about working in our specialist antenatal clinic.

We’ve had an antenatal clinic for people living with HIV since the 1990s. So much has changed since then, with treatment options available; our patients have vastly improved health outcomes compared to the early day of the HIV/AIDS pandemic. Understandably there are still many questions and concerns from our patients about navigating motherhood as someone living with HIV.

We strive to provide our women living with HIV the same care as for any other pregnant woman and to minimise to need for lots of additional appointments. However there is some specialist monitoring we need to do, as well as offering tailored advice and care specific to the patient.

Our service is holistic and multidisciplinary, meaning all aspects of our patients’ health are considered. It can be an extremely busy and fast-paced clinic, but one that we know has major benefit to our patients. In addition to myself and another doctor, the clinic is also run by a clinical nurse specialist, a specialist midwife and an obstetrician, with input from paediatric and virology experts. I’m very fortunate to work with amazing colleagues providing truly patient centred care. Our service also has a strong focus on research and training – an important aspect of our work.

Patients we treat often worry about the safety of their HIV medication in pregnancy, so we are there to reassure them that women around the world have taken HIV drugs safely in pregnancy for over 20 years and on the whole, they're very safe.

Understandably there are questions around whether their baby may be born with HIV – this is known as vertical transmission. Thanks to the incredible advancements in HIV treatment, vertical transmission is at an all-time low and extremely rare in the UK, roughly 2 in1000.

The vast majority of the patients we see are already patients of our HIV outpatients service. It is an honour to support them on their journey, from pre-pregnancy, to conception, to pregnancy, through to birth and post-partum.

As our HIV service sees women living longer and healthier lives, we also support women through their post-reproductive period addressing some of the challenges women may face around the menopause.

It is truly rewarding to be able to let people know that living with HIV is not a barrier to pregnancy or accessing fertility treatment. Living with HIV generally does not impact upon the type of birth you have, with the majority of our patients having vaginal births rather than caesarean. Being there to empower people with the knowledge that with effective treatment, there is an extremely good chance their baby will be born without HIV is a remarkable privilege and signals how far we have come in caring for those women living with HIV.?