{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:02:12Z","timestamp":1789452132812,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Management of pregnancy in women living with HIV is evolving in high\u2010income settings, with increasing attention to infant feeding under sustained virological suppression. Real\u2010world data from Europe remain limited. This study aimed to describe self\u2010reported organizational models and routine approaches to clinical care in participating Italian infectious diseases centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey was conducted among Italian infectious diseases centres via the Italian Cohort of Antiretroviral\u2010Na\u00efve Patients (ICAR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) networks. The questionnaire explored organizational models, ART management, delivery, neonatal prophylaxis and breastfeeding. Data were analysed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010one centres from 15 regions participated, reporting approximately 300 women living with HIV pregnancies in 2024. Most centres (78.0%) had local pregnancy protocols, typically involving multidisciplinary teams. Reported practices varied across several aspects of care, including ART management during pregnancy, obstetric follow\u2010up, mode of delivery and neonatal prophylaxis. Elective caesarean section (CS) was recommended irrespective of virological status in 9.8% of centres; routine intrapartum intravenous zidovudine was reported in 17.1%. Neonatal zidovudine prophylaxis was used by 90.2% of centres (duration: 2\u20136\u2009weeks). Requests for breastfeeding were reported by 53.7% of centres; eight centres supported breastfeeding under strict clinical conditions, involving 36 women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This survey highlights substantial heterogeneity in self\u2010reported organizational models and reported practices among participating Italian infectious diseases centres caring for pregnant women living with HIV. Although direct clinical experience with supported breastfeeding remains limited, the findings support the development of harmonized, evidence\u2010based guidance to promote equitable multidisciplinary care and informed shared decision\u2010making and provide a framework for greater consistency in pregnancy and infant feeding management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70308","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:31Z","timestamp":1789448551000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical management of pregnancy, delivery and breastfeeding in women living with\n                    <scp>HIV<\/scp>\n                    in Italy: A survey of participating infectious diseases centres"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4348-9278","authenticated-orcid":false,"given":"Daniela","family":"Piacentini","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Specialistic Area Department S. Martino Hospital  Belluno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia","family":"Cosimi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Medical, Surgical and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases Istituto Scientifico San Raffaele  Milano Italy"},{"name":"Faculty of Medicine and Surgery Vita\u2010Salute San Raffaele University  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-2945","authenticated-orcid":false,"given":"Annamaria","family":"Cattelan","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padova University Hospital  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2121-4684","authenticated-orcid":false,"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[{"name":"Clinical and Research Department National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Esposito","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Gender Medicine Unit Cotugno Hospital, AO dei Colli  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Frattini","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0892-9039","authenticated-orcid":false,"given":"Vania","family":"Giacomet","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit Luigi Sacco Hospital, University of Milano  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Giupponi","sequence":"additional","affiliation":[{"name":"Lega Italiana per la Lotta contro l'AIDS (LILA)  Como Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Lo","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Infectious Diseases Unit University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Meli","sequence":"additional","affiliation":[{"name":"Don Giuseppe Monticelli Soc. coop. Soc.  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6615-4198","authenticated-orcid":false,"given":"Cristina","family":"Mussini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Azienda Ospedaliera\u2010Universitaria of Modena, University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Nunnari","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Clinical and Experimental Medicine ARNAS Garibaldi Hospital, University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio G.","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0375-9990","authenticated-orcid":false,"given":"Stefano","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases ASST Ovest Milano  Legnano Italy"},{"name":"School of Medicine and Surgery University of Milano  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4674-4772","authenticated-orcid":false,"given":"Massimiliano","family":"Lanzafame","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Province Agency for Health Services S. Chiara Hospital  Trento Italy"},{"name":"Centre for Medical Sciences (CISMed) University of Trento  Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis462"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904\u2010020\u201000530\u20100"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(25)00132\u20108"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/648446"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000212"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ578"},{"key":"e_1_2_10_8_1","volume-title":"Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach","author":"World Health Organization","year":"2021"},{"key":"e_1_2_10_9_1","volume-title":"EACS Guidelines. Version 13.0","author":"European AIDS Clinical Society","year":"2025"},{"key":"e_1_2_10_10_1","volume-title":"BHIVA Guidelines on the Management of HIV in Pregnancy and the Postpartum Period 2025","author":"British HIV Association (BHIVA)","year":"2025"},{"key":"e_1_2_10_11_1","volume-title":"Recommendations for the Use of Antiretroviral Drugs During Pregnancy And Interventions To Reduce Perinatal HIV Transmission in the United States","author":"U.S. Department of Health and Human Services, Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission; CDC; HIVMA; Pediatric Infectious Diseases Society","year":"2025"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12986"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2018.14648"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468\u20101293.2005.00302.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw587"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae027"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001612"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.02.013"},{"key":"e_1_2_10_19_1","volume-title":"BHIVA Conference","author":"Francis K","year":"2023"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2020.0223"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13583"},{"issue":"3","key":"e_1_2_10_22_1","first-page":"215","article-title":"Pregnancy in women living with HIV: experience of IRCCS San Gerardo dei Tintori and a narrative review","volume":"48","author":"Ranzani A","year":"2025","journal-title":"New Microbiol"},{"key":"e_1_2_10_23_1","unstructured":"Aebi\u2010PoppK EggerM VernazzaP et al.Recommendations of the Swiss Federal Commission for Sexual Health (FCSH) for Medical Care of HIV\u2010Infected Women and Their Offspring.2018. doi:10.13140\/RG.2.2.21470.08004\/2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/idr14020027"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13692"},{"key":"e_1_2_10_26_1","unstructured":"Legge 55\/2005.Gazzetta Ufficiale della Repubblica Italiana.2005."},{"key":"e_1_2_10_27_1","unstructured":"Decreto Ministeriale 14 dicembre.Gazzetta Ufficiale della Repubblica Italiana.1995."},{"key":"e_1_2_10_28_1","unstructured":"Decreto Ministeriale 8 giugno 2001. art. 4Gazzetta Ufficiale della Repubblica Italiana.2001."},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/AID.2014.0154"},{"key":"e_1_2_10_30_1","unstructured":"ICONA Foundation.ICONA Cohort. Available at:https:\/\/www.fondazioneicona.org\/"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70308","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70308","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:36Z","timestamp":1789448556000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":29,"alternative-id":["10.1111\/hiv.70308"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70308","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"assertion":[{"value":"2026-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hiv.70308"}}