The median age at transition to adult HIV services in the UK is 17 years [3]; these pregnancies were reported both from paediatric settings and following transition to adult services, with the

median age at first pregnancy being 18 years. In three-quarters of the pregnancies women were reported to have detectable virus close to conception, with potential associated risk of transmission to partners; only half of the partners were reported by healthcare professionals to be aware of the woman’s status up to the time of delivery. While poor uptake of contraception and difficulties with partner disclosure are not limited to adolescence, professionals may need to reconsider their approach to educating this AZD0530 price cohort about contraception and partner disclosure, and consider recommending

effective long-acting reversible contraception in this population. While Liproxstatin-1 barrier contraception is required to reduce the risk of HIV transmission to sexual partners, use is often inconsistent and concentrating on promoting condom use may detract from offering other more effective methods of contraception. Adherence to therapy was reported to be suboptimal at some stage in about half the pregnancies described, with at least one woman requiring hospital admission for directly observed therapy. Problems with attendance and adherence are common during adolescence for many chronic childhood conditions and result in increased disease-related morbidity and mortality [3, 11]. Adolescents living with HIV have poorer adherence to cART compared with children or older adult populations, and poor TCL adherence has also been associated with depression, alcohol and substance abuse, and lack of wider disclosure of HIV status [11, 12]. cART is effective in preventing first-generation MTCT of HIV with overall MTCT rates < 1% with optimal care [13]. In this cohort a single infant was infected, comparable to other reported adolescent cohorts in the USA (one of 30) [9] and a predominantly horizontally infected UK cohort (one

of 66) [10]. Five young women delivered with detectable virus, increasing the risk of transmission to their babies. Multidisciplinary care with the aim of improving adherence to cART during adolescence and particularly during pregnancy should remain a priority; complex social circumstances with frequent social service involvement and high rates of mental health illness should be considered when planning adherence interventions. The rate of preterm deliveries (14%) in this cohort was almost twice the overall European rate in adolescents [14, 15] but similar to the overall rate reported for HIV-positive women in the UK and Ireland [4]. Data are currently sparse on the prevalence of congenital abnormalities in the offspring of perinatally infected adolescents.