Despite being largely preventable, mother-to-child transmission of HIV accounts for 30 percent of all new infections in Malawi and is the second major mode of transmission after unprotected sex. Every year, an estimated 30,000 babies are born HIV positive.
Relatively simple interventions to lower the risk of infection are available to only a small number of women and lag far behind the country's antiretroviral (ARV) treatment programme, which now reaches 70,000 HIV-infected people, or about 40 percent of those who need them.
In 2005, 5,054 women received Nevirapine, an ARV drug that can lower the chances of a mother infecting her baby by up to 40 percent. This was almost twice the number who received the drug in 2004 but, according to UNAIDS, the total number of pregnant women in Malawi who accessed prevention of mother-to-child treatment (PMTCT) services was still only 3 percent.
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This issue has grabbed my passion as transmission from mother to child is preventable.
In "developed" nations such as the U.S., hardly any children contract HIV during pregnancy, labor & delivery or breastfeeding.
Our organization is working with this issue. Our Hope health centers provide PMTCT services to HIV positive mothers and distributes nevirapine. There are obstacles to the treatment besides just receiving the drugs. As I am sure I have mentioned earlier, there is still stigma about even getting tested for HIV. Even when a mother has been tested, she may be hesitant to receive PMTCT services because she fears discrimination from others if she is noticed.
Another challenge is that the majority of women give birth at home/in their village and not at a health center. While this isn't necessarily a problem, since women are sent home with the drug to take during labor and give to their child within the first 72 hours of birth, it has been found that they are less likely to take the medication in this situation. It is hoped that teaching Traditional Birth Attendants (TBAs)about HIV & AIDS and the importance of taking nevirapine will help.
The positive is that we can reduce the chance of transmission to nearly zero with drugs and education.
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2 comments:
Hey Jess,
Yes, I am just reading this post now. ;) I know very little about the drugs used to treat HIV/AIDS, but I do know there are American HIV/AIDS expectant mothers who do not wish to take AZT b/c of the serious potential harmful side effects to their babies. I don't know if this is equivalent to the drug you are referring to or if they are entirely different, however, I do understand and respect a woman's choice to not take drugs of any kind while pregnant. I realize it is a completely different issue in Africa where you were given the stigma, lack of understanding, etc.
My personal opinion is that education (with ANY issue/subject) goes alot farther than drugs. If we can educate people on how to live healthier lives, then there are less we have to treat with drugs when complications, diseases, etc. do occur. Obviously, life happens and there will never be a "zero-occurrence" of anything. I look at it with a similar lens to the vaccine issue. There are others, who feel that I am putting my children in danger b/c we do not vaccinate them against "preventable" diseases. On the other hand, I believe there are more toxins and harmful side effects in vaccines than there are benefits. Since the risks outweigh the benefits for us, we decline the vaccines. Again, a different scope than what you are referring to in Africa, but still related.
Lastly, I think we should all be birthing in our homes and/or small villages. ;)
Shannon
Hey, Shan,
Africa is really different from the U.S., I don't think it can be viewed through the same lens. Yes, behavior change is the ideal, and of course they are working on that. But when a woman's husband will not agree to wear a condom or stop having sex outside the marriage, and she cannot say no to sex with him, she can then get HIV and get pregnant through no choice of her own. Plus, a woman in America who chooses to give birth without taking nevirapine or a similar drug has the medical resources to help her to lessen the chance that the virus will be passed on. Women in Malawi do not have that option. Even if they were to have the money to go to a facility, which few do, there aren't even the resources. In fact, if something really serious happened to me while in Malawi, I would have been helicoptered to South Africa, the closest place with "first world" medical capabilities.
Same goes for homebirth...it's fine with a skilled practioner (they call them TBA's: Traditional Birth Attendants) but because of unskilled TBAs or a lack of TBAs in general, Malawi has one the highest rates of child mortality in the world! So again, I just don't think you can compare to the choices women have in the U.S.
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