Raped And Become HIV Positive

By Brenda Zulu

“I was raped when I was 18 years old in 1993. Due to the history of rape I did an HIV test in 2004 as I had not encountered any sexual relationship with any man. I did not disclose anything to anyone because back then it was very hard. When I was tested I started medication and lived positively. That is when I started sharing information about my status.

In 2006, I got married to an HIV negative man and through counseling and consulting doctors I was able to conceive without infecting him. Throughout the pregnancy I was monitored until I delivered and chose not to breastfeed and that was a personal choice. I gave birth to an HIV negative baby and my partner is still negative because we follow precautions,” said Sophie Bwalya.

Sophie is one woman among many women who has managed her HIV status and the fact that she wanted to taste the joy of motherhood, being HIV positive did not stop her having a baby.

 According to the 2010 National Protocol Guidelines, under the integrated prevention of mother to child transmission (PMTCT) of HIV, the 2010 guidelines emphasize the introduction of more efficacious regimes and extended Nevirapine administration for the infant during the breastfeeding period as recommended by the World Health Organisation (WHO).

In Zambia, PMTCT services are available to address the burden of vertical transmission of HIV. With a high antenatal HIV prevalence estimated at 16.4 percent in 2008, approximately 80 000 infants born annually are at risk of acquiring HIV from their mothers. Integration of PMTCT into all maternal, newborn and child health services throughout the country will contribute to a significant reduction of transmission of HIV and subsequent child morbidity and mortality.

The entry point into the PMTCT programme for every pregnant woman and her partner is knowledge of their HIV status. The programme encourages a family centered approach. HIV testing is part of the routine Antenatal Care (ANC) services and results and post test counseling are provided for on the same day.

HIV infection transmitted from an HIV-infected mother to her child during pregnancy, labour delivery or breastfeeding is known as Mother-To-Child Transmission (MTCT). The prevention of mother-to-child transmission (PMTCT) is a highly effective intervention and has huge potential to improve both maternal and child health.

Mwelwa Nsabika a Nurse and Tuberculosis (TB) focal point at Kara Counseling and Research Center observed that health centers still face challenges in administering PMTCT programmes as some HIV positive women who are on medication will not say beforehand when they want to conceive.

  “It was important for an HIV positive woman to ask the health care provider beforehand if they wanted to conceive. This is very important for women who are already on medication because they will be taught the right time to conceive and monitored if there is need to change medication,” said Nsabika.

She added that the other challenge was that not all women were able to attend the clinic with partners as some were not willing. “This is important because they need to have protected sex during pregnancy and not expose the partner to HIV,” said Nsabika.

Speaking about family planning, Nsabika pointed out that all family planning was safe for HIV infected mothers except for the intrauterine device (IUD) of which health personnel have taken precautions in case the woman has another infection which could be a sexually transmitted disease (STD) or an inflammatory disease.

“In many cases we advise mothers to use dual family planning method for people on Lopinavir and Nevirapine as all family planning has a failure rate,” said Nsabika.

She explained that among HIV-infected women, the prevention of unintended pregnancies was essential for preventing mother-to-child transmission of HIV. She said HIV positive women are given all the information on family planning but those who intend to conceive were also asked to visit the clinic with their male partners.

She said male partners’ role in the PMTCT services was important in Zambia as couples were taught the right time when the woman could conceive which was between the 11^th  day from the first day she had her monthly period to the 14^th day although it is not guaranteed that the woman will be pregnant.

“That is the right time when HIV positive couples can meet without a condom and it should not be everyday because there is need to let the sperms mature so that they are not weak,” said Nsabika.

“Being HIV positive does not mean that you cannot have a child who is healthy. It is also important to go for cervical cancer screening which is also raised when one has HIV,” she said.