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Heather Roy's Diary 17 June 2005

Heather Roy's Diary

HIV Testing in Pregnancy

A decision has recently been made to add testing for Human Immunodeficiency Virus (HIV) to the battery of tests routinely offered to pregnant women. This issue has been around for some time and its implementation is a little overdue. HIV is the virus that causes AIDS and when the pregnant mother is infected the chances of the infection being passed to the baby are significant- around 30% to 40%.

The test is not compulsory and the mother can decline it if she insists but experience shows that most patients accept a battery of routine tests. If the disease is diagnosed then treatment can be implemented which protects the baby and the chance of transmission is small. In other words, the medical case for testing is strong and if we don’t do it then it is only a matter of time until a baby is born with HIV infection that will later turn into AIDS. There has already been at least one case in New Zealand of a woman who was pregnant carrying the disease but treatment was implemented.

In parts of Africa, where the incidence of AIDS is high, there are a large number of babies born with HIV. This has been a particular problem in South Africa where the government took the quixotic position that AIDS is not caused by the HIV virus.

To my surprise the College of Midwives has criticised the decision to offer testing to all pregnant women, saying that they don’t have the training or resources to help women who test positive. There was never any expectation that midwives would manage AIDS patients themselves. Most doctors would require the assistance of an infectious diseases expert but doctors groups have welcomed the initiative.

The College of GPs said any screening programme that helps prevent the further spread of the HIV virus is to be applauded. It is hard to believe that midwives could really think it is better not to know that a pregnant woman has AIDS or is infected with the HIV virus because they don’t feel able to cope with the condition.

The College of Midwives’ chief executive Karen Guilliland has said that the money would be better spent on screening for chlamydia. Chlamydia is a problem but it isn’t as serious as AIDS and it is much harder to screen for.

The College of GPs is rightly worried at the reported remarks of the College of Midwives. The real difficulty is that maternity care has moved away from integrated care, at the instigation of the College of Midwives - in fact they have fought a successful campaign to have GPs excluded from maternity care and deliveries.

Disappointing Diplomats

The Government has had some difficulty of late with some of their overseas diplomatic appointees.

Previous Speaker Jonathan Hunt famously inquired into the possibility of drawing a British pension, in addition to his already generous salary, two minutes after arriving in the United Kingdom. Then he sat in the back of his car during an ANZAC Commemoration ceremony because it was raining. It took more than a little rain to put off the few remaining soldiers who fought to ensure our freedom in New Zealand on ANZAC day.

This week, attention turned to Canada where the High Commissioner to Canada, Graham Kelly, was deemed to have made inappropriate comments about Maori and Asians to a Canadian Senate Committee. As well as publishing his comments the New Zealand Herald reported that Mr Kelly has been forced to abandon his plans to attend the funeral in New Zealand of former Labour MP Sonja Davies. I guess the Prime Minister just doesn’t want to be seen with Graham Kelly in election year despite the fact that she appointed him to the job.


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