Disclose, save lives

in love with Farai (not real name too) since they were first year students at the university. They have both been lucky to secure employment at firms where they served as interns.
Everything went according to book and the two tied the knot. Farai is the eldest in a family of six and has set a standards for his siblings. Rutendo is the perfect daughter- in-law who is the pride of the new family. With brains, beauty, good job and a supporting husband she is the envy of many people.
Rutendo was a virgin when she tied the knot and true to her upbringing she vowed not to have sex before marriage.
The two lovebirds were true to each other.
There was no need to go for an HIV test since the two had never indulged.
They were lucky, in the first year of their marriage they were expecting. Rutendo’s doctor suggested she took an HIV test which she reluctantly agreed to. The results were a shock to Rutendo and Farai and they thought there was a mix up since the tests had been done at a laboratory. The doctor advised they visit a Voluntary Counselling and Testing Centre where the results were immediate.
On visiting the VCT, the two were counselled and a rapid HIV test was done. The results confirmed the doctor’s statement that Rutendo was HIV positive and the husband was HIV negative. The two were shattered and shocked. How could that be?
Rutendo is one of the many children born HIV positive and today many of them are adolescents. Many like Rutendo are now ready for marriage. A doctor speaking on condition of anonymity confirmed that there are people who are genetically strong and did not get ill from the virus.
These people were usually referred to as late stage developers but there was nothing unusual about them.
“There are some people who are just resistant and do not fall ill from HIV-related diseases. They may get sick here and there but they do not develop any HIV-related illness,” said the doctor.
What should the community do to help such youths now that they are ready to begin families? Rutendo enrolled at her local clinic for antenatal classes. She is lucky because nationally the Prevention of Mother to Child Transmission (PMTCT) has been rolled nationwide.
She is a happy mother today, her son now seven weeks has tested HIV negative. Rutendo’s story of mothers knowing their status after visiting an antenatal clinic is familiar with many women.
The Elizabeth Glaser Paediatric Aids Foundation (EGPAF) had by March 31, 2010 provided 755 000 women with PMTCT services from 620 national sites by end of 2009.
Psycho-social support is important when one tests HIV positive, worse still when pregnant.
All PMTCT programmes provide this support in people living positively.
People have to know that they are not alone and by sharing the stories of their lives they move on.
Rutendo and husband are the only two people who know of her status apart from the health personnel. Acceptance is a process and at least she is not in denial but just afraid of the reaction from family members especially the in-laws.
“I was shattered when I tested HIV positive but scanning back, my dad passed away.
“He got so ill and was wasted and bedridden when I was a toddler and when I was 10 years my mother’s health faltered.
“I have never had a blood transfusion nor did I have a sexual liaison with anyone. I am not bitter but my mom tested HIV positive when I was 15. I am glad she is now on ARVs and doing well,” said Rutendo.
Rutendo has not even told her own mother she does not know how she would take it. People need to know that there is confidentiality of results and health personnel observe the 3Cs. These are counselling, care and confidentiality.
Many women familiar with Rutendo’s situation now have hope of giving birth to healthy babies which was a pipedream a decade ago. From 2000, a single dose of nevirapine was given to a pregnant mother which she would take when labour kicked off.
Today, stronger drugs known as More Efficacious Regimens (MER) are used in preventing the transmission of the virus from the mother to the baby. This vertical transmission can now be eliminated using MER. Any other form of transmission is horizontal.
Infections among children under the age of 15 is usually vertical. A baby may get infected whilst in the womb, at birth or during breastfeeding.
Breast-feeding accounts for 40 percent of Mother to Child Transmission (MTCT), 40 percent at labour and delivery with the remainder when baby is still in the womb.
One such woman who received support through the PMTCT is Mrs Claris Chauruka. When Claris went home and disclosed to her husband that she had tested HIV positive during an antenatal clinic test, she did not get the support she expected.
“At first my husband was not supportive but I enrolled on the PMTCT programme,” Claris said.
She gave birth to a son who tested HIV negative at 18 months. She exclusively breastfed for the first six months and introduced other foods as porridge and pumpkins from then. She weaned the baby from breast milk at 12 months.
Today the husband Pitiel has accepted his status and they are now both members of an active support group hosted by EGPAF. Pitiel is one of the few father mentors working in their community.
Mr Chauruka said that the men’s support was crucial as women who had their husbands by their side healed faster as compared to those who did not have spousal support. He, however, noted that men were not as open as women about their status, they found it difficult to open up.
“At first many HIV-positive men who attend the support group don’t admit their status. They may ask questions and we reassure them and help them come to terms with their diagnosis,” he said. He went on to add that the support group worked as a family.
“Our support group is like a family. We sing, dance, we talk and we teach, we laugh and we cry. But everyone is equal,” said Chauruka.
Doctor Angela Mushavi who is the National PMTCT and Paediatrics HIV Care and Treatment Co-ordinator in the foundation said PMTCT is everyone’s business.
She called for the proportions of new HIV infections from mother to child to be reduced by 90 percent. Dr Mushavi said that every child born by an HIV positive mother was exposed to the virus hence the interventions. She urged primary prevention as the pillar stone of making an HIV-free generation possible.
“The provision of care and support for HIV-infected women and the safety of their infants is our duty,” she said.
Pregnant mothers should register early and from 14 weeks any mother in need of PMTCT services has this availed. If the prevention fails and the baby is infected then baby is started on medication immediately at 6 weeks. Some may ask why 6 weeks, why not day 1?
Babies can only be tested at 6 weeks hence that time factor. Prior to that the baby is given only cotrimoxazole (an antibiotic) to avoid baby getting infections.
“We initiate baby on treatment if baby tests HIV positive at 6 weeks and they can live healthy and normal lives as long as medication is adhered to,” said Dr Mushavi. Pregnant HIV positive mothers now need to know and be assured that it is no longer gloom and doom. They need to enroll on the PMTCT programmes. It can not be administered from your homes. One has to visit an ante-natal clinic.
The national PMTCT programme is only reaching 49 percent of all HIV positive pregnant women in Zimbabwe. In developed nations no child is born HIV positive because the figure is close to 100 percent.
The foundation in conjunction with its partners, the Ministry of Health and Child Welfare has provided critical support to Zimbabwe’s PMTCT programme.
It is active in 700 sites in 35 districts.
No child should be born HIV positive if the mother cares enough to ensure that – with PMTCT it is now possible to eliminate new infections in children.
In line with the Millenium Development Goals, it is possible to eliminate new infections in children to less than 5 percent by 2015.
Until then, God bless.
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