An HIV- Positive Baby? - Femina

That got you thinking, didn't it?

Let me give you some more food for thought.

According to figures available in late 2003, there are 17.8 lakh women who are living with HIV. Most of them are in the reproductive age group, and there is equal chance that at least half of them live in the urban areas, in cities like Mumbai (HIV prevalence has gone up considerably in the past year), Delhi and Kolkata. In all these cities, as in many others, there has been a steady rise in HIV cases, and the numbers can be quite alarming.

Also take into consideration the fact that many of these HIV-infected women lead active sex lives, and might even be unaware of their HIV-positive status.

What does such a woman do, when during her visit to the gynaec, she discovers that she is not just pregnant, but HIV-positive too?

Let us set aside for now, the emotional upheaval such a woman will face and live through. The guilt, the self blame, the suspicious and angry words exchanged with her partner, more likely than not her husband and only partner sexually. Hanging over it all, like the sword of Damocles, is the fact that she need not just fear for her own life, but for that of the one she is carrying.

Maybe she will ask these questions, or maybe her doctor will tell her anyway, but the ways in which a foetus can get infected with the HIV virus are four-fold:

* Mother-to-child transmission can happen if during conception, the viral load is very high. In lay terms, it means the foetus gets infected if the virus is rampant in the mother's system at the time of conception,

* An infection of the reproductive tract during pregnancy increases chances of the infection being transmitted,

* A wound inflicted by the forceps during delivery could again be one means of infection from mother to baby,

* And lastly, during breast feeding.

Statistics show that in the worst case scenario, 30 per cent of babies born to mothers who are positive are infected, or get the infection after birth from their mothers. So there is an even chance that despite the status of the mother-to-be, the child will not be born carrying the virus.

Careful counselling and monitoring can ensure that a positive mother does not necessarily infect her baby.

The safeguards are many and posted all along the route to a positive woman giving birth to a healthy baby who can grow up without contacting the virus from her at least.

A woman who knows her positive status can lessen the chances of a positive status for her baby if she tries to conceive when her viral load is low.

Mothers-to-be who discover their status for the first time at the antenatal clinic have the option of aborting the foetus and getting on to a course of treatment.

Should they, however, decide to complete the term and have the baby, they can take recourse to what counsellors call the Nevropine option. This means the drug is administered to the mother before the labour pains begin, during labour, and the baby too, gets a dose after eight weeks.

In case routine testing, that includes HIV tests from the third to seventh month of pregnancy, detects a shift in the mother's status, the Nevropine option is also relied on, but a tablet of Zidavidine is administered in the seventh month to the mother. This lessens the chances of mother-to-child transmission considerably.

Breast-feeding is another route for the virus to travel from mother to child, and an HIV-positive mother is well advised to rely on top feeds. However, tests carried out by NACO (National Aids Control Organisation) do point out that contrary to popular belief, breast fed children showed a lower rate of infection for the first four months than top-fed babies.

Regular monitoring of the baby through the four months of breast feeding, and shifting to a bottle or other top feed at the first sign of falling immunity, is a safe way of preventing mother-to-child transmission.

The other side of the picture

Kaushalya is the President of the Positive Woman's Network (PWN), based in Chennai. She started a PWN in 1998 to meet the need to address women's issues linked with HIV/ AIDS. Working across 13 states and 58 districts, the NGO tries to bridge the gap between the government and the public, and to get help to the needy but HIV-positive women. Kaushalya, who spoke up at the AIDS Conference in Bangkok, highlighted the catch-22 situation that faces HIV-positive mothers-to-be from the rural and semi-educated classes. "Usually, a woman will decide to drop the baby, fearing it will get the virus from her," she explains, as she paints the situation that prevails in Tamil Nadu, which has been declared a 'high prevalance state'.

Though the governments of a few states like Tamil Nadu and Karnataka support these networks, there is need for closer intervention. Government recognition of PWN could empower people like Kaushalya and her group to reach out on an one-to-one basis to help innocent women who might otherwise suffer the double tragedy of suffering from HIV/AIDS and the guilt of passing it on to their newborns.