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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