It is possible that some pregnancies in eligible patients were not recorded in the computerized hospital databases which might have resulted in underestimating the number of pregnancies included in the study

period. In addition, the small number of pregnancies reported makes our findings entirely descriptive. However, this study identifies a need for more effective strategies in the management of HIV-infected teenagers with particular emphasis on sexual and reproductive health. This may be achieved by establishing specialist HIV services for adolescents and teenagers within HIV networks. A multidisciplinary team facilitates the provision of comprehensive, seamless and integrated services with appropriately tailored reproductive health services. Within specialized services, teenagers would Androgen Receptor inhibition receive a one-stop shop service including HIV care, sexual and

reproductive health input and psychosocial support in an appropriate environment provided by skilled staff in a sensitive and nonjudgmental manner. To conclude, this study is the largest in Europe looking specifically at pregnant HIV-infected teenagers. Although pregnancy and virological outcomes are favourable in this group, there is Trametinib a strikingly high level of social vulnerability and poor sexual and reproductive health resulting in a high rate of further unplanned pregnancy. This is of considerable concern especially as this may be an underestimate because of the amount of missing data. Prospective analytical multicentre studies to identify HIV-infected teenagers’ medical and social needs and barriers to contraception and adherence in the United Kingdom are clearly warranted. These should be complemented by qualitative research that explores the complex socioeconomic factors that drive risk

taking and sequential pregnancy in this vulnerable group. We acknowledge Rozanna Issa, Specialist Midwife-Sexual Health, Robyn Cross, Paediatrics Clinical Nurse Specialist and Veronica Magaya, Clinical Nurse Specialist at Guy’s and St Thomas’ NHS Foundation Trust. “
“5.1.1 It is recommended that women Bumetanide conceiving on an effective HAART regimen should continue this even if it contains efavirenz or does not contain zidovudine. Grading: 1C Exceptions are: (i) PI monotherapy should be intensified to include (depending on tolerability, resistance and previous ARV history) one or more agents that cross the placenta. Grading: 2D (ii) The combination of stavudine and didanosine should not be prescribed in pregnancy. Grading: 1D Despite the lack of licence for the use of ART in pregnancy, with the exception of zidovudine in the third trimester, there is global consensus that women who conceive on effective HAART should continue this throughout the pregnancy.