The Royal Free Hospital delivers comprehensive sexual and reproductive healthcare to HIV-positive women and their partners who are patients at the clinic. We have a dedicated HIV specialist midwife and obstetrician for pregnant women, and a dedicated cervical smear clinic, colposcopy clinic and gynaecology clinic, all of which run on Wednesdays within the ICDC. The Royal Free Hospital was the first HIV unit in the country to have a dedicated women's clinic.
Women with HIV need more frequent smears. These can be done (along with a STI screen if requested) on a Wednesday. Alternatively, some women prefer for these to be taken by their GP service.
Testing for STIs can be performed by the sexual health nurse in the ICDC or self-testing if requested by the patient.
Our gynaecology clinic is run by a consultant gynaecologist. Women may be referred to this for advice regarding contraception, fitting of coils and implants and management of gynaecological problems including menopausal symptoms.
There is a monthly clinic based in ICDC. It is run by a consultant in lower genital tract gynaecology.
Antenatal and paediatric HIV services
The antenatal and paediatric HIV services are a part of the HIV specialist team within the Royal Free Hospital and operate under a multidisciplinary approach. Since recent commissioning changes, HIV positive children will be followed up at either Great Ormond Street Hospital, St. Mary’s or St George’s Hospitals which are now paediatric HIV specialist centres.
In accordance with national antenatal guidelines, all pregnant women are encouraged to have an HIV test. The aim is that all women have access to clear, accurate information to make an informed choice about HIV testing. All babies of HIV positive mothers are under the care of the paediatrics team until they have completed their HIV testing between eighteen and twenty-four months old. The multidisciplinary team has a philosophy in line with the children’s National Service Framework (NSF).
Paediatric guidelines indicate that all children who may be at risk of HIV should be tested. Testing is discussed with parents and in an age appropriate way with children. Testing is strongly encouraged for children who have symptoms, have one or both parents known to be HIV positive, or are children of high risk parents. Children who have been exposed to needle-stick injuries are also encouraged to take a test.
Both antenatal and paediatric clinics actively support those babies and children who are HIV positive. We offer a family-focused, highly specialist service for children and families infected or affected by HIV. Many young people have now been transitioned into adult services and there is a multidisciplinary specialist approach to supporting the transition process.