HIV Sperm Washing NorthWest

posted: 08/02/2011

Sperm washing for people with HIV is now available in North West England. Sperm washing cuts the risk of HIV transmission for couples who want a baby, when the male is living with HIV but his female partner is HIV negative. Sperm washing cuts the risk of passing HIV to the female partner and of the mother then passing HIV to the baby.
 

More information on sperm washing and HIV here

New sperm washing service in Liverpool

A Liverpool clinic now offers sperm washing and fertility services to people with HIV and other blood borne viruses.
People wanting sperm washing before now have had to travel around 200 miles to London.

Dr Chitra Babu (from the Hathersage Clinic at Manchester Royal Infirmary), has worked with the Greater Manchester Sexual Health Network to arrange in principle for funding to pay for this sperm washing, as a way of reducing the risk of HIV transmission.

HIV positive men with HIV negative partners who want to have children should both go together and talk with their HIV clinic about sperm washing and other ways to cut HIV transmission risks. Liverpool can also provide other fertility treatments – talk with your local HIV clinic.
 

Leaflet for patients and guidelines for clinics

Within the next couple of weeks there will be a leaflet for couples affected by HIV and guidelines for clinics, and we will then add these here.

Information Sessions - HIV and having a family

Positively UK are holding two HIV and Pregnancy information sessions at George House Trust:

Preconception and Pregnancy:
Saturday 19 February 2011
13:00 – 15:00

Delivery and After Care:
Saturday 19 March 2011
13:00 – 15:00

Both men and women are welcome to attend.

If you need a space for a child at the crèche, please book this in advance

For further information contact Jill Cooke at GHT on 0161 274 4499 or email her, or Angelina from Positively UK on 0207 713 0444 or email her

More information on HIV and pregnancy

• i-Base booklet HIV, Pregnancy and Women's Health
• MyHIV - having a family pages from the new website for people with HIV in the UK
• Aidsmap's booklet for Women
• HIV and Sexual Health in Pregnancy - Manchester Maternity Hospitals HIV Information Pack from Manchester Public Health

HIV and Pregnancy Sessions

posted: 08/02/2011

Find out more about safely having a family with HIV. We have two information talks and discussions for people with HIV who are thinking about having children or who want to find out more.

• HIV positive and pregnant?
• Thinking of starting a family?
• Would you like to find out more about HIV and pregnancy?

Positively UK are holding two HIV and Pregnancy information sessions at George House Trust:

Preconception and Pregnancy - planning for a baby
Saturday 19 February 2011
13:00 – 15:00

Delivery and After Care - having and caring for your baby 
Saturday 19 March 2011
13:00 – 15:00

Both men and women are welcome.

Crèche?

If you need a space for a child at the crèche, please book this in advance with Jill by phone or email - please tell her which date you need the crèche

More information

For more information please call Jill Cooke at GHT on 0161 274 4499 or email, OR Angelina from Positively UK on 0207 713 0444 or email

New - sperm washing in Liverpool

A clinic in Liverpool is now able to provide sperm washing and fertility services to people with HIV and other blood borne viruses. People with HIV will no longer need to go to London.
 

More information on HIV and pregnancy

i-Base booklet HIV, Pregnancy and Women's Health 

MyHIV - having a family pages from the new website for people with HIV in the UK

Aidsmap's booklet for Women

HIV and Sexual Health in Pregnancy - Manchester Maternity Hospitals HIV Information Pack from Manchester Public Health

Infant Feeding Guide

posted: 23/04/2010

The advice for new mothers with HIV is not to breastfeed, but to use milk formula instead, because there is a small risk of HIV transmission through breast milk. New, draft, guidance from the British HIV and Children’s HIV Associations (BHIVA/CHIVA) updates this message and continues to advise women in the UK not to breastfeed, whatever the woman's viral load and antiretroviral therapy.
 

Milk formula is best

All HIV positive mothers should be supported to formula-feed their infants. This means that formula milk and appropriate equipment (including sterilisers and bottles) must be freely available, as part of the package of care to prevent mother-to-child transmission.
 

In the UK the risk of mother-to child transmission from a woman who is on HAART and has a consistently undetectable HIV viral load is likely to be low, but we don’t know the exact risk.
 

Although formula feeding is still the best and safest option in the UK to prevent mother to child transmission of HIV, if a woman is on effective HAART and chooses to exclusively breast-feed having carefully considered this advice, she should be supported to do so as safely, and for as short a period, as possible.
 

Don't mix breast and formula
The exact risk of mixing breastfeeding with milk formula feeding is not known, but mixed feeding is not recommended. If there is to be any breastfeeding, breast feed only. 

Intensive support and monitoring of the mother and infant is recommended during any breast-feeding period.

Monthly maternal viral load testing is recommended.

To identify any drug toxicity or HIV transmission in the infant, monthly HIV assessment is advised.

Draft Infant feeding guidance
Comments by Friday 21 May 2010 here please

HIV+ Mother and Baby Loss

posted: 24/03/2010

The HIV positive mother of a 10 month old baby boy died two days after her own son, who starved to death. The real causes of the mother and baby deaths seem to be the mother’s mental ill-health and HIV stigma, along with missed opportunities and possible failings by health and social care services.
 

The 10-month-old boy wasted away in his pram at his mother's London flat where he was seen at least 15 times, in six months, by nine care professionals. Although experts were concerned about the child's deteriorating health, not enough was done to save the child, because officials and help were turned away by the mother.
 

The baby was found dead, emaciated and surrounded by rotting food on March 8 after a 999 call from his mother's council flat. The post-mortem showed his stomach was empty and he had not eaten for days. He had suffered a 'long period of malnourishment' and his weight had plummeted since Christmas by a third, to 12.5lb.
 

Interpreter refused because of stigma fears

Police began a murder inquiry and his 29-year-old migrant mother was arrested for child neglect. She had avoided contact with care services by saying her human rights would be breached if they used an interpreter to question her - in case the close-knit Eritrean community found out she had HIV. She was allowed to keep both her baby boy and his four-year-old sister.
 

Mum's failing mental health

There were concerns about her parenting skills, she was 'hearing voices' and had expressed fears for her baby's health. After her arrest she was rushed to hospital after only an hour, where she died two days after her son, from a rare brain condition linked to HIV.
 

George House Trust comment
 

This item is based on a Daily Mail news report (the only source we have found) that blamed health and children’s social services for the baby’s death.

We think that the real story is that

• The mother was seriously mentally ill with a rare HIV-related rare brain condition and seems not to have had treatment for this. Her own neglected long-term mental illness caused the child's neglect – like she neglected her own health, dying just two days after her son.
• The mother was very worried by HIV stigma and rejection by the local Eritrean community. So she refused to allow services to use any interpreter because she feared her HIV status would then become known among Eritreans.

There is not enough information to fairly judge whether health and social care services failed, because the Daily Mail's confidential information came from just one of many services that were involved. 

Lessons and issues

However it does appear that there are useful lessons to be learned from holding a multi-agency case review. It's not simply about 'what should have been done to protect her baby boy' but about meeting her own needs for mental health support and treatment. There are difficult ethical dilemmas - like everyone else she has autonomy, the right to decide about her own treatment and care. No-one can force competent adults to have treatment they don't want. But was she able to look after her own health when she was showing significant symptoms of mental distress? And should we use different rules when there is a baby involved? Why wasn't telephone interpretation provided (this would have protected her identity)?

This was a family of three in crisis for some months and only the baby seems to have been of concern - the whole family's situation and needs seem to have been overlooked.  

HIV stigma is dangerous

This is one more case demonstrating why challenging and ending HIV stigma, especially among vulnerable migrant communities, is so important.

Some more detail on the deaths and the events leading up to these

In September 2009, she was rehoused in London after moving from Birmingham after she was beaten up by her partner. A series of visits by health visitors and social workers from Westminster City Council followed. But despite a growing file of evidence that all was not well, nothing was done. The last visit to the flat in St John's Wood was made on March 1. A week later, the boy was dead in his pram. A neighbour said: 'We used to hear her baby and an older child crying all the time. On March 8 my son heard a scream at around seven in the morning.'
 

Two health trusts were responsible for the family. A confidential report by one of the trusts - the Central and North West London NHS Foundation Trust said: 'Post mortem results on the infant showed that he had no food in his gut at all and so had not eaten for several days at least. However, there is evidence of a long period of malnourishment.' But, after a nine-day investigation, the report concluded there are no lessons to be learnt.
 

Michael O'Connor, Westminster City Council's director for children and young people, said: 'Neither of the children were on the child protection register and there is no suggestion that they were at risk.'

Terry Bamford of Westminster's Local Safeguarding Children Board, said an independent serious case review would take place. Central and North West London Trust refused to comment and Imperial College Healthcare NHS Trust said it was carrying out its own inquiry.