Talk:HIV and pregnancy

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Pavikavarma. Peer reviewers: VeronicaNicole88.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:04, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 4 January 2021 and 29 January 2021. Further details are available on the course page. Student editor(s): Rdwing08. Peer reviewers: Hy097231.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:04, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 30 August 2021 and 21 September 2021. Further details are available on the course page. Student editor(s): Elianacicucsf, RioBC, Sp3454. Peer reviewers: Wmsims1, Akyang1996, Medmoon.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:04, 17 January 2022 (UTC)

Peer Review

Excellent work! I have just a few suggestions for the article:

The Lead:

-add in (ART) after antiretrovirals are first mentioned in the lead.

-add something more to information about US and HIV birth rate (seems like a sentence without any introduction. How was Cuba able to rid mother-to-child transmission of HIV? (very impressive)

Pregnancy Planning:

-when speaking about serodiscordinant couples, perhaps mention that the infection can spread to the child as well

Prevention of mother-to-child transmission to the end of the article:

-there is interchange between “anti-HIV medications” and “ART”-perhaps state either one or the other to ease understanding

-perhaps change this sentence:

“If, before her scheduled cesarean delivery, a woman's water breaks or she goes into labor, a Cesarean section may not reduce the risk of mother-to-child transmission of HIV”

to

“If a woman’s water breaks or she goes into labor before her scheduled cesarean section, then performing a cesarean section may not reduce the risk of mother-to-child transmission of HIV”

-or something a little easier to understand/less commas

Medications during pregnancy:

-expand on the medications, what is an NRTI? Maybe just add in a short description if the person does not want to click on the link

Postnatal care:

“Within 6 to 12 hours after delivery, babies born to women infected with HIV are recommended to receive zidovudine (AZT), and to continue this medication for 6 weeks”- add in what these medications are, remind that they are anti-retroviral medications

“Testing for babies is done using a virologic HIV test.”-what is this test?

“In developing countries, the WHO balances the low risk of transmission through breast feeding from women who are on ART with the benefits of breastfeeding against diarrhea, pneumonia and malnutrition”

-maybe clarify by including something about “breastfeeding has been shown to boost a child’s ability to fight diarrhea, pneumonia, and malnutrition”

-maybe add in a concensus statement on what the WHO believes a woman should do, breast feed or not breast feed in developing countries?

Hope this helps!

VeronicaNicole88 (talk) 23:15, 16 November 2015 (UTC)VeronicaNicole88

Remove banner?

Can we remove the banner? Global guidelines have largely harmonized so there's not as much need for "worldwide" perspective and the recent large update by Pavikavarma did broaden certain topics. Looks like it was placed by FloNight

--Pgcudahy (talk) 13:56, 17 December 2015 (UTC)

2019 update

More needs to be added about exclusive breastfeeding. Does it need a separate page or would the advice be to add more to the main breastfeeding page. Generally some HIV information needs updating. For example, the advice is now that all HIV positive women should be taking antiretrovirals. TamaraStaples (talk) 17:22, 24 December 2019 (UTC)

What do you feel is missing regarding the information on exclusive breastfeeding? I haven't read the breastfeeding section of this article for years and was actually surprised to find so much information, though perhaps some of it may be out of date and I'm not aware of it. BTW, it seems that it would be good to see someone improve the lead of this article.:Gandydancer (talk) 14:42, 26 December 2019 (UTC)

UCF COM WikiProject Medicine Course 2020

Hello! I am a 4th year medical student participating in a WikiProject Medicine course at UCF COM. We were instructed to choose a medical article and edit/update the current article over the next 4 weeks. I am proposing making the changes denoted below, and I would greatly value any feedback from the Wikipedia community throughout this process. Thank you very much!

General Changes

• Update recommendations with the most current published guidelines from the CDC, WHO, ACOG, etc.
• Address prior concerns mentioned on the Talk pages, particularly in regards to exclusive breastfeeding

Lead Section

• Streamline lead section and eliminate extraneous information. For example, the discussion of Cuba's eradication of mother-to-child HIV transmission is interesting and important, it is more appropriate information for the body of the article and not the lead. It is does not fit into an overview of the important points about the topic.
• Add necessary citations: there are many statements made that could use high quality citations
• Improve current statements/citations to the most up-to-date recommendations from the CDC/WHO/ACOG, etc.

Layout I intend to update the structure of this article to align with WikiProject Medicine's suggested diseases/disorders/syndromes layout, which is described below. While the current article has some great information and high quality writing, the structure is convoluted, and it is challenging to both follow and locate specific information. My suggested layout offers a straightforward order of information that is easier to digest and find the necessary information that pertains to this disease process. While this is an interesting article because it focuses on a disease in a specific patient population, I still believe this format makes the most sense for presenting the information in a clear and concise manner.

• Mechanism: I will create a section discussing the basics of HIV mother-to-baby transmission (crossing the placenta, vertical transmission, dependence on viral load, and immune status of mother). I also intend to explain these concepts, particularly viral load, in a concise manner. Some of this information is addressed in the current "Prevention of Mother-to-Child Transmission" and I think it should be moved here. It would make the information easier to locate nad focus the prevention section on specifics related to that topic.
• Characteristics/Presentation: I will create a short section on relevant presenting symptoms with a sub-section for mom and a sub-section for baby.
• Diagnosis/Screening: I will update the current sections that relate to this information. I will include 2 sub-sections: HIV testing in pregnancy and Pregnancy Planning (both of which are addressed in the current article). I will update the recommendations with the most recent guidelines and I will update the citations to ensure they are not primary sources but more Wiki-appropriate citations. Notable important changes will include: addressing follow-up third trimester HIV screening in high risk mothers per the CDC, streamlining the information on the opt-in/opt-out model as it is quite long in the current version, and addressing/clarifying HIV testing methodology.
• Treatment/Managemet: I intend to combine the current sections titled "Prevention of mother-to-child transmission", "Labor and Delivery", "Medications", "Considerations During Pregnancy", "Postnatal Care", and "Breastfeeding" into this section. In order to clarify the current guidelines, I will make 3 sub-sections, "Prenatal Care", "Postnatal Care", and "Antiretroviral Medications". I think it is appropriate to separate out the specific information on the antiretroviral medications in regards to their safety profiles in pregnancy. As they are currently written, the section is very long-winded and confusing. The discussion of Vitamin A supplementation also needs to be addressed, as the teratogenic affects of high doses of Vitamin A are of note. In the Prenatal Care section, I will address the following topics based on CDC/WHO/ACOG guidance: prevention of mother-to-child transmission with ART therapy, labor and delivery guidelines, immunization guidelines, and screening for other diseases (STIs, HCV, HBV, syphilis, drug abuse). In the postnatal care section, I will keep most of the information in the current section as it is well written, I will add information on Infant Treatment and Follow-Up, and I will update and streamline/clarify the information on the current breastfeeding guidelines in both the developing countries and developed countries per prior suggestions on the Talk page. I will specifically modify some of the information in the current breastfeeding section, including: the successive mentioning of studies on HIV transmission that were mentioned as they are primary sources and distracting from the specific guidelines for the reader, and I will eliminate the recurrent mentioning of South Africa as the only example of a developing country as I believe it potentially biases readers into thinking the HIV burden only affects African developing nations and not those in other parts of the world. These previously mentioned topics also contain a lot of medical jargon and discussion of specific medications at a professional level as they are currently written, and I will try and simplify the terminology and conversation to make it more Encyclopedia-appropriate.
• Outcomes/Prognosis: I will add a short section that addresses outcomes nad prognosis in an infant HIV infection, childhood HIV infection, and adult HIV infection. I will also move the current section on informing children living with HIV of their status to this section. This is important information that is discussed at length in the CDC's database, however, it needs an updated citation and updated guidelines as it is currently written.
• Epidemiology: I will add a short section addressing the current burden of HIV in pregnant women in the USA and internationally, and I will address children born with HIV.
• Society and Culture: I will move the current section on discrimination during pregnancy to this section. It is currently well written and does not requrie much change to the current content. I will try and find some citations regarding discrimination faced by pregnant women with HIV in the developed world as well as the currently mentioned developing world.

As I mentioned, I appreciate any feedback the Wiki community has! I look forward to working on this project and helping to make it a high quality article.

Thanks! Rdwing08 (talk) 03:50, 8 January 2021 (UTC)

UCF COM Peer Review

@Rdwing08 Awesome job! You've added so much information to this page. Be proud!

Lead

· Very nice lead that brings up the importance of HIV involved in pregnancy

· Good idea to mention how risks can be lowered

· It well reflects important information covered in the rest of the article

· Minor suggestion: The 5th sentence of the first paragraph ("According to...") is a bit hard to follow.

Content (on sections author specifically added)

Transmission Mechanism

· Good addition to the article. I can see that you want to stress how the transmission can be prevented. It may appear redundant to some but you styled it nicely so I'm personally OK with it.

Clinical Characteristics/Presentation

· Overall, easy understand and helpful

· Great images. I remember you being concerned with the rash picture but you clearly noted that it is not associated with HIV necessarily. I have no concern regarding that picture just like we agreed during our last meeting.

· The only suggestion I have is maybe adding some links to some of the symptoms and signs you describe (like Kaposi, candida, etc)

Diagnosis/Screening

· Great work on adding so much information!

· Suggestion: Is there any reference you can add for the second sentence ("Both risks can be...")?

· Minor Suggestion: In the second last paragraph, maybe consider saying "it is vital" or "it is important" instead of "vitally important"

HIV Testing in Pregnancy

· Again, great job! It doesn't show if you added the "further information" link but if you did, a great idea!

· Minor Suggestion: The last sentence of the second last paragraph ("If the initial antigen/antibody...") is a little bit hard to follow

Treatment/Management

· So much addition plus I really like the minor edits you've done to already existing contents

· Suggestion: Under Labor and Delivery, can you specify viral load range like you did in Prevention section? Like adding "HIV RNA" to "(less than 1000 copies/mL)" in the second paragraph and "(greater than 1000 copies/mL)" in the third paragraph

· Suggestion: Under Vaccination, need reference for the last sentence of the first paragraph ("Vaccination is important...")

Antiretroviral Medications During Pregnancy

· I really like how you started this section by stating the goal. Everything looks great in this section!

Postnatal Care

· Flows very nicely and easy to understand

· super minor suggestion: typo in the last sentence of Infant Treatment and Follow Up - mrother

Tone and Balance

• Content is all neutrally conveyed in an appropriate manner, no bias or heavy-handed claims, no persuasion all evidence based and clear

Sources and References

• All new content backed up by reliable sources (secondary) + all links work fine and most references are up to date

Organization

• Well organized in a sensible order

Media

• Great addition of the pictures. I know it is hard to find relevant pictures for this topic.

Overall Impressions:

You have done a tremendous job in adding so much information to this page. Your edits to the already existing contents helped with their flow too.

I really love how you describe certain medical terms in lay terms even when you could have just linked them to another wiki page. I can tell that you really thought of the future readers!

Great job and you should be proud of yourself!! :D Hy097231 (talk) 15:34, 28 January 2021 (UTC)

This is the best student work I've ever seen. I did find the lead too long, so much so that I started to get lost in the info. I'd suggest that in the third para following this sentence: "The American College of Obstetrics and Gynecology(ACOG) therefore recommends..." you do a great deal of trimming. I made a couple of edits that seemed an improvement to me but feel free to revert anything I do. Great job. Gandydancer (talk) 04:21, 29 January 2021 (UTC)

For all headings only the first word is capitalized. See for example Diagnosis of HIV/AIDS. Gandydancer (talk) 11:35, 29 January 2021 (UTC)

Workplan by UCSF SOM Students

Article chosen: HIV and Pregnancy

Why this one? Include WP rating scale? How fit with your interests. Other details as desired It was rated as a high importance article but graded as a “Start” which is a fairly low on the wikipedia grading scale. HIV and pregnancy is a stigmatized topic and thus we would like to review the article in a way that dispels stigmas.

You WP editing team (up to 3) Rio Barrere-Cain and Eliana Kim

Initial Analysis of the article Well-organized and thorough, last edited by a group of students several months ago in January 2021. It seems like it contains a lot of medical jargon and could be improved to be more accessible and comprehensible to the public/pregnant people with HIV.

What will you add? More gender inclusive language (ie changing mother to gestational parent or birthing parent) More images and pictures of different skin tones More citations and links throughout the article More information on resources and support groups for parents living with HIV

What will you remove? Gender binary terms Some medical jargon

What will you augment? Use of non-medical jargon Augment section on stigmas and discrimination for parents who have HIV and become pregnant

What will you decrease coverage of? Not applicable

Roles in the project. List members and planned roles. Possible roles include: Overseer/amalgamator/reconciler Readability editor Researcher Editor/writer-what sections will each do? Linker, for larger groups consider someone who will check the articles linked to make sure that the linked material is sufficient and accurate Images/graphics

Linker - Eliana Researcher/Writer for Discrimination section - Rio Resources and Support groups - Eliana and Rio Images - Eliana Editing medical jargon and editing in general - Eliana does section 4, Rio does 1,2,3,5

Team coordination plan: 9/10 Friday Check-in Mtg - Eliana to send Zoom invite

WIP presenter Since we are just two people Eliana and Rio will tag team

Impressions & Feedback: 9/13

• • I think this looks great and I appreciate the changes that you are/planning to make. Just one feedback is that I would explain the use of nonbinary language so everyone who visits the page can understand why nonbinary language is used throughout the text.

Great ideas to improve this page. Given how thorough it is, I appreciate how you all focused on unique aspects that would make it more appropriate for all relevant populations.

• • From Adrienne: It would be nice to change the wording of the first sentence, so there is not such a sharp contrast between ‘HIV and pregnancy’ and ‘HIV in pregnancy.’ I definitely agree that there should be more gender-inclusive language to replace words like ‘woman’ and ‘breastfeeding’ (including the entire section focused on ‘breastfeeding’). I like the idea to include more information about disparities in who receives access to general healthcare and HIV-specific care in the period before getting pregnant and how that influences pregnancy outcomes. I was a little confused by the title of the subsection (‘Society and Culture’); perhaps change that title to ‘How Society Impacts HIV and Pregnancy.’ It would make a lot of sense to include the new information about disparities within that subsection (formerly titled ‘Society and Culture.’

Gender neutral language

@Sp3454: Per this discussion, there is site wide consensus not to use gender neutral language. We should be using the same language the overwhelming number of reliable source use. Thank you. Boghog (talk) 04:22, 21 September 2021 (UTC)