Perinatal transmission: A mother's story

Perinatal AIDS is now a preventable disease according to Lynn Mofenson, a US-based researcher who spoke at the first plenary session of the 12^th World AIDS Conference. As long as five years ago, she said, studies showed that AZT given prophylactically to pregnant women could reduce HIV transmission by 50% or more. Combined AZT and HIV immune globulin (HIVIG) regimens are effective, even in cases of advanced infection, Mofenson said, noting that when babies are delivered by Caesarean section, the rate of mother to child transmission can be reduced to less than 1%.

Recognising that antiretroviral therapies have been unavailable to people in the vast majority of developing countries, Mofenson outlined a number of globally applicable interventions. These included primary prevention programmes, availability of prenatal HIV testing, and education regarding prenatal smoking, drug use, multiple sex partners and unprotected sex. She also emphasised the need for obstetric interventions such 1) basic prenatal care, including multivitamin supplements, 2) C-sections where the risk of the child contracting HIV is not outweighed by danger of surgery to the mother, 3) vaginal microbicides during labour, 4) the development of safe alternatives to breast milk.

this story can also be found in The Bridge, the onsite print newspaper

Mercy Maklahemena, from South Africa, described her personal experience as an HIV-positive mother whose infant daughter died of maternally-transmitted AIDS. "My baby was put on AZT at birth," she said, "but no one told me not to breast feed." In addition, no physician ever thought to explain the common side effects of AIDS treatment -- so when her daughter spent her first year in and out of hospital with swelling, vomiting and diarrhoea, Maklahemena felt helpless. At last, she stopped the AZT, and noticed an immediate improvement. "She walked, she ran, she picked up things," Maklahemena said. "Then she developed a persistent cough." A friend persuaded her to take the baby to hospital, and by next morning, her child was dead.

Maklahemena's experience underlines the importance of women demanding the best, most complete information from physicians. "How is it that doctors so far have not been taking a more holistic, long term view of women's lives?" she asked. "They must remember that when the doctor has left the stage, we are still here. Out of the torn threads that are left of our lives, we must try and make new clothes."

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