Abstract

Making protocols work – Bradford Royal Infirmary serves a multiethnic population in one of the most deprived areas of the UK. The annual delivery rate exceeds 6000, of which 0.2% are HIV positive. A local pathway, established in 2008, streamlines the care of a condition often shrouded in stigma. A simple title of ‘Goldstar patient’ instantly declares their status without prejudice and constant repetition to health professionals.

Improved maternal outcome – Rapid progress in our unit has banished the compulsory LSCS pre-2008 to allow those with an undetectable viraemia the option of a normal vaginal delivery. 50% of our HIV patients are identified in pregnancy, highlighting the need for a protocol in any unit irrespective of size or location. Women, who often return to countries without safe healthcare systems, can look to a future without the morbidity of major surgery. To date no baby has vertically acquired HIV. Educating the team – With intensive education and a logical protocol, Bradford has transformed its care of HIV in pregnancy. Professionals involved now understand what can be offered and how to access help and care, including ‘out-of-hours’ situations, limiting confusion and error.