We will look to regularly update this page with information about the projects we are taking forward.
In 2010, the IDPS Programme commissioned a national study to investigate how many screen positive syphilis test results result in a diagnosis of maternal syphilis requiring treatment. The Surveillance of Antenatal Syphilis Screening (SASS) study operates along the same lines as the HIV surveillance, and started data collection in April 2010 after receiving ethics approval.
SASS is a two year study and is being carried out in parallel with national surveillance of congenital syphilis (2010-2013) conducted by the HPA.
There are 221 SASS respondents covering the whole of the UK, and they are being asked to report all pregnant women with a positive antenatal syphilis screening test from January 2010 onwards. During the first year about half of all respondents indicated that they had no eligible pregnancies to report, while about a third reported between 1 and 3 pregnancies each.
Early indications are that almost a quarter of reported screen positive cases turn out to be false positives, and about half of those with probable current or past syphilis require treatment, most because they are newly diagnosed, but for about 25% because of lack of documentation about previous treatment.
We expect a report, summarising key findings, at the end of 2012.
The IDPS Programme Team and the MRC Centre of Epidemiology for Child Health have started scoping a project which we hope will contribute to the monitoring and improvement of antenatal HIV screening protocols and contribute to a further reduction in the risk of perinatal HIV transmission.
Despite high uptake of antenatal HIV screening, and effective interventions to prevent mother-to-child transmission, some UK-born children still acquire infection from their mothers: about 1% (10-15) of the 1200-1300 infants born each year to diagnosed HIV-positive women are infected. Another 20-30 newly diagnosed children are also reported each year who were born in the UK but whose mothers were not previously known to be HIV-positive. These women were either not tested in pregnancy, or acquired HIV after their antenatal test later in pregnancy or after their baby was born and while they were still breastfeeding.
The MRC Centre of Epidemiology for Child Health intend to establish a protocol to seek additional information about the antenatal screening and management of the mothers of newly diagnosed infants and young children. This will build on an earlier audit of perinatal transmissions which resulted in a number of recommendations now embedded in British HIV Association (BHIVA) and antenatal screening guidelines.
We hope this audit will become embedded as part of the National Study of HIV in Pregnancy and Childhood.