New HIV diagnosis in pregnancy — communication and management station

Communication and management station: a new HIV diagnosis in pregnancy. Tests the immediate combined prevention strategy, the multidisciplinary team activation, the partner-notification and confidentiality handling, the viral-load-driven mode-of-delivery planning, and the setting-dependent infant feeding counselling. Includes assessor timeline, marking domains, assessor key and fail criteria.

Prompt

You are the registrar in the antenatal clinic. A 24-year-old G1P0 woman at 22 weeks gestation is found to have a positive HIV screen, confirmed on HIV RNA viral load of 22,000 copies per mL. Her CD4 count is 510 cells per microlitre. She is well. She has a partner of two years who is unaware of the result. The assessor runs the clock and feeds you the woman's responses and the multidisciplinary team inputs.

Station brief

Format. Communication and management station, approximately 12 minutes. You are the registrar in the antenatal clinic. The infectious diseases physician and the midwife specialist are available by phone. The assessor runs the clock and feeds you the woman's responses and the team inputs. ^[1]

Candidate instruction. Lead the immediate management and counselling of a woman with a new HIV diagnosis in pregnancy. Verbalise your clinical reasoning, your prevention plan, your handling of partner notification and confidentiality, and your communication with the woman about the mode of delivery and infant feeding. ^[1]^[2]

References4Show

[1]Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group N Engl J Med, 1994.PMID 7935654
[2]Townsend CL, Byrne L, Cortina-Borja M, Thorne C, de Ruiter A, Lyall H, Taylor GP, Peckham CS, Tookey PA Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011 AIDS, 2014.PMID 24566097
[3]Peters H, Byrne L, De Ruiter A, et al. Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study BJOG, 2016.PMID 26011825
[4]Dadabhai S, Chou VB, Pinilla M, et al. Effects of preterm birth, maternal ART and breastfeeding on 24-month infant HIV-free survival in a randomized trial AIDS, 2024.PMID 38427596

New HIV diagnosis in pregnancy — communication and management station

Station brief

References4Show

[1]Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group N Engl J Med, 1994.PMID 7935654
[2]Townsend CL, Byrne L, Cortina-Borja M, Thorne C, de Ruiter A, Lyall H, Taylor GP, Peckham CS, Tookey PA Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011 AIDS, 2014.PMID 24566097
[3]Peters H, Byrne L, De Ruiter A, et al. Duration of ruptured membranes and mother-to-child HIV transmission: a prospective population-based surveillance study BJOG, 2016.PMID 26011825
[4]Dadabhai S, Chou VB, Pinilla M, et al. Effects of preterm birth, maternal ART and breastfeeding on 24-month infant HIV-free survival in a randomized trial AIDS, 2024.PMID 38427596