In this video episode of Let Women Talk, HIV community advocate Sarah Feagan speaks with Dr Carole Khaw — a Sexual Health and HIV Physician working at the Royal Adelaide Hospital and a Senior Lecturer in Medical Education, School of Medicine, University of Adelaide, at the 2019 Australasian HIV&AIDS Conference held in Perth on 17-19 September. Sarah asks Dr Khaw to speak about one of her patients; whose case study was presented in a poster at the conference: A conundrum in the management of a HIV positive woman who conceived on Dolutegravir with deviations from guidelines.
- Download the interview transcript [PDF]
About the poster
In May 2018, the World Health Organisation (WHO) issued a statement regarding the potential safety in Women Living with HIV (WLHIV) using Dolutegravir (DTG) at conception. Preliminary unscheduled analysis of an ongoing observational study in Botswana (Tsepamo study) found 0.94% (0.37% to 2.45%) incidence of neural tube defects in infants of Botswanan women conceiving on Dolutegravir compared to 0.12% (0.07% to 0.21%) incidence in infants born to women taking other combination antiretroviral therapy (cART) at conception. This resulted in interim guidelines from the Department of Health and Human Services (DHHS) and European AIDS Clinical Society (EACS) recommending that DTG should not be used in pregnant women in the first trimester and that women on DTG be switched to other combination antiretroviral therapy pre-conception.
Dr Khaw’s case study shows the journey of one female patient. Despite the release of the WHO statement, the patient was fully involved in the decision-making process of whether or not to make a treatment switch, and informed of the risks and benefits, before and during her early pregnancy. She decided to remain on DTG (and continues to be virally suppressed), having deviated from the DHHS and EACS guidelines, eventually giving birth to a healthy baby, who remains HIV negative. The case in particular demonstrated the importance of individualised, woman-centred approach to care. Despite some guideline recommendations at that time, the patient’s voice and the right to self-determination was critical.
Related links
- Download the poster [PDF] — A conundrum in the management of a HIV positive woman who conceived on Dolutegravir with deviations from guidelines
Find out about Let Women Talk
Let Women Talk is a NAPWHA community-led health literacy initiative where HIV community advocates incorporate their rich perspectives and diverse lived HIV experiences back into strengthening community health responses — where women design and develop the health content and interventions that they want to see and hear. The initiative is one of many activities forming part of the HIV Health Literacy Framework Project, a NAPWHA project supported through the funding of ViiV Healthcare Australia.
Hear other video episodes
In this series, Sarah Feagan reports back from the 2019 Australasian HIV&AIDS Conference aiming to translate research back into community practice.
- Let Women Talk — Episode 01 — Sarah Feagan & Deborah Bateson
- Let Women Talk — Episode 02 — Sarah Feagan & Mina John
- Let Women Talk — Episode 03 — Sarah Feagan & Janet Gare
- Let Women Talk — Episode 04 — Sarah Feagan & Jenny Hoy
- Let Women Talk — Episode 05 — Sarah Feagan & Diane Lloyd
- Let Women Talk — Episode 07 — Sarah Feagan & Kirsty Machon
- Let Women Talk — Episode 09 — Sarah Feagan & Rebecca Houghton
- Let Women Talk — Episode 10 — Sarah Feagan & Melinda Hassall
- Let Women Talk — Episode 11 — Sarah Feagan & Shoshana Rosenberg
- Let Women Talk — Episode 12 — Sarah Feagan & Liz Duck-Chong
- Let Women Talk — Episode 13 — Sarah Feagan & Moira Wilson
- Let Women Talk — Episode 14 — Sarah Feagan & Allie Carter
Who’s in this interview?
Dr Carole Khaw is a Sexual Health and HIV Physician working at the Royal Adelaide Hospital and a Senior Lecturer in Medical Education, School of Medicine, University of Adelaide. She is a graduate of Monash University and was in General Practice for many years before returning to training in Sexual Health Medicine.
Sarah Feagan is a queer women who has been living with HIV since 2008. She is the previous chair of Positive Women Victoria and has recently joined the team at Living Positive Victoria as a Peer Navigator. She also the Vice President of NAPWHA. Sarah is a co-facilitator of Phoenix for Women and the Positive Leadership Development Institute (PLDi). Sarah has unique approach to her advocacy and is inspired by the lived experience of the body positive to inform her practice. Sarah’s advocacy spans the from the grass roots all the way up to high level governance. She has a global outlook with a local focus to bringing the community along with her.
