Description:
<jats:sec><jats:title>Key content</jats:title><jats:p>
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<jats:list-item><jats:p>In the UK, the proportion of HIV‐positive pregnant women diagnosed before delivery is around 95%.</jats:p></jats:list-item>
<jats:list-item><jats:p>The benefits of highly active antiretroviral therapy (HAART) in reducing mother‐to‐child transmission are undisputed; however, there are potentially adverse effects on maternal and fetal/neonatal health.</jats:p></jats:list-item>
<jats:list-item><jats:p>Vaginal delivery may be considered for HIV‐positive pregnant women with undetectable viral loads who are on HAART.</jats:p></jats:list-item>
<jats:list-item><jats:p>Hormonal contraception can be affected by drug–drug interactions with HAART or nonantiretroviral medication that HIV‐positive women may be taking.</jats:p></jats:list-item>
<jats:list-item><jats:p>Although HAART can alter the natural history of cervical intraepithelial neoplasia (CIN), annual cervical cytology is still recommended.</jats:p></jats:list-item>
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</jats:p></jats:sec><jats:sec><jats:title>Learning objectives</jats:title><jats:p>
<jats:list list-type="explicit-label">
<jats:list-item><jats:p>To be aware of the different types of HAART, their use and associated maternal, fetal and neonatal toxicities.</jats:p></jats:list-item>
<jats:list-item><jats:p>To be able to critically evaluate the place of prelabour elective caesarean section in light of recent developments in viral load testing and HAART.</jats:p></jats:list-item>
<jats:list-item><jats:p>To be aware of potential drug–drug interactions that can reduce the efficacy of hormonal contraception in HIV‐positive women.</jats:p></jats:list-item>
<jats:list-item><jats:p>To appreciate the potential impact of HAART and the recently developed human papillomavirus vaccines on the natural history of CIN in HIV‐positive women.</jats:p></jats:list-item>
<jats:list-item><jats:p>To know where to find up‐to‐date information on drug–drug interactions and clinical vaccine trials relating to HIV.</jats:p></jats:list-item>
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</jats:p></jats:sec><jats:sec><jats:title>Ethical issues</jats:title><jats:p>
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<jats:list-item><jats:p>Clear communication about the potential risks and benefits of strategies to reduce mother‐to‐child transmission is critical to enable HIV‐positive pregnant women to reach informed decisions about their care.</jats:p></jats:list-item>
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</jats:p><jats:p>Please cite this article as: Kelly B, Morrison J, Hurley P. Recent developments in HIV and women's health. <jats:bold>The Obstetrician & Gynaecologist</jats:bold> 2008;10:42–48.</jats:p></jats:sec>