Prevalence of HIV infection among women giving birth in the UK is monitored through an unlinked anonymous survey based on residual neonatal dried blood spots. This has been in place in London since 1988, other selected English regions since 1990 and Scotland between 1990 and 2008. The survey provides an estimate of overall HIV prevalence in women giving birth regardless of whether or not they have been diagnosed. Nationally, estimated prevalence increased gradually during the 1990s, more rapidly between 2000 and 2005, and has since stabilized. In 2009
the survey covered over 400 000 births, and estimated HIV prevalence was 2.2 per 1000 women giving birth (1 in every 449). Prevalence in London was about 1 in 350 in 2000, rising to 1 in 250 by 2003 and has been relatively stable since then. In the rest of England, about buy 3-MA SB431542 supplier 1 in 3500 women giving birth was HIV positive in 2000, rising to 1 in 700 by 2006, and remaining stable since then. In Scotland prevalence increased from about 1 in 2150 in 2000 to 1 in 1150 in 2008 [,]. The majority of HIV-positive pregnant women are from sub-Saharan Africa with prevalence stable between 2004 and 2007 at about 2–2.5% among sub-Saharan African mothers giving birth in London, and slightly higher at 3–3.5% among sub-Saharan women giving birth
elsewhere in England. Although prevalence among UK-born women giving birth remained low at about 0.46 per 1000 women (1 in 2200) in 2009, a gradual increase has been seen since 2000 when it was 0.16 per 1000. In the UK, the rate of HIV MTCT from diagnosed women was 25.6% in 1993, at which time interventions were virtually non-existent Resminostat . Between 2000 and 2006, with high uptake of interventions, the overall transmission rate from diagnosed women was 1.2%, and <1% among women who had received at least 14 days of ART. Among more than 2000 women who had received HAART and delivered with an undetectable VL, there were only three
transmissions, an MTCT rate of 0.1% . These very low transmission rates persist. A small proportion of HIV-positive women remain undiagnosed at delivery in the UK, which probably means that currently about 2% of all HIV-exposed infants (born to diagnosed and undiagnosed women) are vertically infected . By 2010, over 98% of all diagnosed women received some form of ART before delivery: the proportion of those who were taking zidovudine monotherapy dropped from about 20% in 2002–2003 to <5% since 2006, and only about 2% in 2009–2010. Over the same period the proportion of women delivering by elective CS declined from about two-thirds to just over one-third, while vaginal deliveries increased from <15% of all deliveries to almost 40%.