Carrying you baby HIV positively

‘My partner was so happy when I told him that I was pregnant in 2003. We decided we would not immediately tell our relatives about-it-looking forward to what their faces would look like when they’d see my belly stick out,’ narrates Eunice.

‘My pregnancy was pretty normal save for the expected morning sickness which lasted only a few weeks. My appetite was good and my energy levels were normal. I did not start attending clinic until the sixth month. An old friend advised me to visit a local mission hospital as it had good facilities and the costs were bearable,’ says Eunice.

‘On my first visit, at 26 weeks, the nurse did the routine checks, and took notes on my progress. Before I left the examination room, the nurse casually asked me whether I had taken a HIV test. I said I hadn’t and she advised it would be good to take one for the sake of the baby. So if I were interested, she would place the request and have me take the test at the hospital’s laboratory then come for the results on my next visit, which would be in a month’s time.

‘I went back home and mentioned to my partner about my antenatal visit and the nurse’s advice. He did not think it was a big deal. So during my next clinic the routine checks were done and the male nurse said all was well-the foetal heartbeat, baby’s position and all. As I got out of the examining bed, he looked at my file again. “You had done some tests last time, and the results are here.” he said, “You did two tests, the VDRL is negative but the HIV test is positive.” I let out a small laughter. “That’s not the kind of reaction I expect, I just told you that you tested positive to HIV,” said the nurse. Without thinking I answered, “I know it’s not true.” “But that’s what the test results show,” he said. “There must have been a problem with your machine or maybe they gave me somebody else’s results, I think its better I take the test again.” ‘I took another blood sample and left the hospital. My next visit would be in two weeks time. Needless to say the second test turned out positive again.’

The good news is. Eunice went ahead to have her baby. The boy is now 6 years old and most importantly, HIV NEGATIVE. Eunice’s story is however not the only of its kind. According to the National AIDS and STD Prevention Program (NASCOP), about 78,000 women in Kenya test HIV positive in pregnancy every year. Without any medical interventions. 20- 42 per cent of these women could transmit the virus to their unborn child. Mother to child HIV transmission (MTCT), occurs either during childbirth or through breast-feeding.

The Ministry of Health recommends that, pregnant women who attend antenatal clinic have to undergo a routine HIV test. This is in line with the Prevention of Mother to Child Transmission (PMTC ) programme. Kenya’s PMTCT program aims to reduce HIV infection in infants by 50 per cent before 2010. The programme involves several interventions right from the time an expectant mother tests positive, to child birth, through to the first year of the child’s life.

Going back to Eunice’s case, after she tested positive in her last trimester, she was immediately put on the PMTCT programme. She was made to do other tests including a CD4 Count test to determine the strength of her immunity. Luckily her CD4 count was above 700, which meant her immunity was strong enough to handle the pregnancy without any medications. Dr. John Ong’ech, a gynaecologist and leading researcher at Kenyatta National Hospital’s PMTCTs department explains that when the CD4 is above the recommended WHO standards, pregnant women do not have to be started on anti-retroviral drugs (ARVS). However, he advises that even then such women should be followed up closely throughout the pregnancy. He says, ‘We need to monitor these women closely, as they are at risk of getting other infections which could bring their immunity down very fast.

However. when the CD4 count is below the recommended level, we normally advise that these women start on ARVS as soon as possible but preferably after the first trimester’. Other PMTCT measures adopted by the Ministry of Health include, a mother being given a single dose of nevirapine at the onset of labour with the baby receiving a dose immediately after birth. Birth by caesarean section is also advisable as is formula feeding. instead of the otherwise recommended exclusive breastfeeding for the first six months of life.

Eunice says. ‘I am glad I found out about my status therefore. I was able to take measures to protect him from getting the virus. However. mothers should be properly counselled before they take the tests-particularly in pregnancy.’ She adds, ‘Mothers should be able to understand the implications of a positive result, especially after the baby is born. I chose not to breastfeed my baby. You can imagine how many questions I had to answer from relatives and friends. I also had to wait until my son was one year to confirm his status. All these were emotionally draining especially because I did not receive proper counselling before and after my HIV test.’

That happened to Eunice six years ago. Today PMTCT services have advanced in Kenya. For example. you may not have to wait the one year to confirm your baby’s status, with advancement in technology; a confirmatory test can be done at six weeks! As you ponder on this. make sure to have your HIV test early enough in pregnancy or better still. before you conceive! GOOD LUCK!

END: PG 28 /42