admin
changing and prevention of sexually transmitted diseases now topical, dual protection is now advocated in people living positively with HIV.
Why two-way protection? Is one method not effective enough?
It is known that the spread of sexually transmitted diseases can be curbed with the use of condoms. Charity and husband had planned on a family of three.
They did not afford to add any more as their college-going daughter’s needs were eating into the family’s purse.
They were yet to complete building their house in the city on a home-improvement sche-me with a local bank.
As a couple living positively, they used condoms for family planning and as a tool against sexually transmitted infections and re-infection too and this was effective.
When Charity started to feel nauseas, she dismissed this to the new cooking oil they were using and the heat since temperatures were in the high range.
She never suspected that she could be pregnant. After sometime she stopped feeling sick without having taken any medication.
She stayed at home without suspecting that she was pregnant.
Charity is heavily built and she now speaks of her living tale with a forked tongue.
“Only young girls may not know that they are pregnant since it’s unfamiliar happenings, but to say an old woman like me can get to near term without having raised a whiff is fiction material,” said Charity as she suckled her three months old baby girl at a forum for people living with HIV (PLHIV).
Charity and husband used condoms since they tested HIV positive in 2000. They have had no problem in their sexual life.
Then with the coming on board of the female condom, life got bearable as both now had the power to protection. It was not just the male, even Charity could use the female condom, there was now a choice.
Charity today is a peer counsellor at her local clinic as she speaks on positive living with ease.
Recently at the monthly bulletin, she spoke on the need of dual protection for PLHIV.
“Who would have imagined that when I started to feel a bit sick in the morning that was because I was pregnant, I never imagined so, we used condoms as prescribed for over a decade and did not see this as a possibility,” said the now mother of four.
All condom batches entering the country through normal channel are tested by the authority.
There are, however, cases where some condoms end up on sale in the hands of some unscrupulous people and these would have been imported by individuals so these escape the rigorous test.
Condoms are made of latex and are sensitive and proper care must be taken.
It is not surprising to find condoms on display in a shop window or table where direct sunlight penetrates.
When condoms are exposed to heat there is risk and the use of such could be the cause of some unplanned pregnancies and STIs when a condom burst yet one would argue that they used condoms as prescribed.
Charity says that they experienced only one burst condom but then that was during the time the husband was disposing.
She now thinks it could have burst during intercourse but had not noticed it. Charity found out that she was pregnant when she had gone for a pap smear which she does twice a year at her local clinic.
A pap smear is a procedure that tests a woman of cervical cancer traces. Instead the nurse told her that she was nearly full-term and no pap smear could be done until she had given birth.
She thought the nurse was joking.
“To say I was shocked is an understatement. At first I thought it was a joke in bad taste but when she insisted that I book with the ante-natal clinic that is when it dawned on me that I was pregnant,” said Charity.
“Now taking events that had occurred about eight months ago, I realised that the morning sickness I felt then was the first trimester of my pregnancy.
“I walked home like a zombie and could not even eat for the whole day,” she said.
“It was even more difficult for me to accept that I was pregnant.
“Testing HIV positive is shattering but I had moved on well and accepted my status, but now here I was refusing to accept that I was pregnant,” she added.
Charity is one of the many women who unintentionally find themselves pregnant.
An unplanned pregnancy causes a couple to worry and is stressful especially when HIV positive.
When an HIV positive mother decides to have a baby, there are a lot of health considerations.
Firstly the health staff or doctor has to check on the CD4 count.
In some developed countries a viral load is done and this is more accurate since it tells the amount of virus in the blood.
Charity was already on ART but she received more efficacious regimen drugs to ensure that the virus was eliminated from mother to child.
Vertical transmission which is commonly known as mother to child, accounts for 90 percent of child infections.
Charity went on to say that she only heard of dual protection after she was already pregnant.
So this time around she was making it her duty to inform all HIV positive mothers that they needed to have ‘double’ protection.
“Condom use alone is not enough, you can never tell if these were properly kept, some could have been exposed to the sun which makes them prone to breaking,” she added.
Charity’s baby tested HIV negative at six weeks, since she is breastfeeding, she will have the baby tested again.
She therefore called on women living positively to either use the contraceptive tablets, depo-provera or the norplant, what ever they were comfortable with.
One woman asked if it was okay to have both husband and wife use the condoms.
This was not advised, latex on latex does not work, so the dual does not imply using both the male and female condom.
It means the mother continues with the oral contraception or the injection and then as a safety measure against sexually transmitted diseases, HIV included, they use the condom.
As much as it is the HIV positive mothers’ right to have children, it must be noted that elimination of the virus from the mother to the child remains of paramount importance and is the duty of both the parents, so this now is prevention from parents to child transmission.
We usually refer to the transmission as PMTCT because it is the mother who carries the term and actually is the one to pass on the virus even though two parents maybe involved.
Charity is exclusively breastfeeding as advised until the baby turns six months.
After six months, milk will no longer be adequate for the baby so solids will be introduced gradually as she continues to breastfeed.
Milk is complete food for babies under the age of six months.
In communities and families we live, we have seen infants under six months given porridge when the baby cries.
It is usually said that the baby is hungry hence the crying.
This is not true, the crying may be due to some discomfort. Babies’ alimentary canals are not yet developed to have solids pass.
The digestive system itself is not yet ready so babies must never be given solids.
Solids damage the lining of the gut making bruises and through these openings, the HIV virus enters the baby.
If the baby has no bruises, it is passed out in the stool.
That is why mothers have to at least disclose to those who remain with the baby in their absence why they must never be given solids. May all pregnancies be planned and avoid vertical transmission by booking early (14 weeks) at the nearest ante-natal clinic.
With the Ministry of Health and Child Welfare working in conjunction with the Elizabeth Glaser Foundation and its partners in running PMTCT programmes at antenatal clinics nationally, it is now possible to prevent mother to child infection.
They envisage to eliminate new HIV infections in children to less than 5 percent by 2015.
Until then, be blessed.
[email protected]
Online Reporter