Karleen
Thanks for that synopsis, which is very reassuring and helpful.
I also found this:
Australian govt report on communicable diseases, 2009
<http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3204e.htm>http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3204e.htm
Perinatal exposure to HIV and HIV infection
Ms Ann McDonald, National Centre in HIV
Epidemiology and Clinical Research In 2007, 29
cases of perinatal exposure to HIV were reported.
Four children were born to women whose HIV
infection was diagnosed postnatally. HIV
infection has been confirmed in three of these
children, while 1 child is HIV negative.
Twenty-five children were born in Australia to
women whose HIV infection was diagnosed
antenatally. None of these children have been
diagnosed with HIV infection. Twenty-three
mothers used antiretroviral therapy in pregnancy
and avoided breastfeeding. Antiretroviral
treatment and mode of infant feeding were not reported for 2 women.
Antenatal diagnosis of the mother's HIV infection
and use of interventions continues to minimise
the risk of mother-to-child HIV transmission.7
Ref
7. McDonald A, Zurynski Y, Nadew K, Elliott E,
Kaldor J, Ziegler J. Prevention of
mother-to-child HIV transmission in Australia,
1982–2005. J Paediatr Child Health 2007;43:A11.
You made the suggestion that if milk recipients
wanted to make their risk microscopic they would
just need to restrict their donors to those born
in Australia. The stats I've found in the past
for Western Europe suggest a similar scenario,
that locally-born, indigenous HIV+ European
mothers are very few in number. Most
HIV-infected women living in W Europe were born
in sub-Saharan Africa, and most likely came from
countries in East and Southern Africa, or had
recently visited these countries. Or had
partners who were born there, or had recently
visited. In 2010 I attended a NICE consultation
in London which was tasked with increasing
HIV-testing for black Africans in England. While
I lived in Africa the word "black" had been
erased from my speech and writings, so I was
shocked at what I interpreted as a kind of
blatant racial discrimination being openly
promoted, and I said so (I was the only person
present to speak up....) But the swift retort
from the chairperson was that "That's where the
problem is". The NICE consultation lasted over
a year and was carefully done, with input from a
wide range of organizations. The press release,
23 Mar 2011, about the rationale for the final
NICE guidance to increase HIV testing in black
African communities in England, is available
at
<http://www.nice.org.uk/media/DE4/00/2011052HIVBlackAfricans.pdf>http://www.nice.org.uk/media/DE4/00/2011052HIVBlackAfricans.pdf
In Europe, the UK owns the major problem of HIV,
and the numbers of HIV+ women giving birth in
other European countries are fewer, but of those
who do, most also come from sub-Saharan
Africa. So similar restrictions about European milk donors might be wise.
Pamela
--------------------
Pam Morrison alerted me to the following paper
https://www.mja.com.au/journal/2009/190/8/perinatal-exposure-hiv-among-children-born-australia-1982-2006
The numbers of HIV positive women who give birth
in Australia is very small- about 25 a year. Of
these 25, 21 or these women would be born in
Sub-Saharan Africa. Less than 1 Australian-born
HIV positive woman gives birth each year. The
risk of HIV transmission via milk sharing in
AUstralia is tiny, tiny tiny. If milk recipients
wanted to make their risk microscopic they would
just need to restrict their donors to those born in Australia.
Karleen Gribble
Australia
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