Sacrificial Mothers

Things have really changed with HIV over the years. About 5-15 years ago, many HIV-positive women gave birth to babies who contracted the virus from them and died. In fact, many mothers and fathers learned of their own HIV status through their sick child. But now we know many HIV-positive mothers who are giving birth to HIV-negative babies.

What has changed?

1) The mothers are on ARV (anti-retroviral) drugs which suppress the HIV virus in their systems.

2) Many give birth by scheduled c-sections in order to reduce the transmission of the virus.

3) Immediately upon birth, the babies are given ARV drugs which are continued for the first 6 weeks of life.

4) Women are told not to breastfeed in order to reduce the transmission of the virus.

In the last five years, about 15 of the HIV+ women  I work with have given birth. I can only think of one child who is HIV-positive out of the 15. The odds are definitely in the favor of the child when the above regimen is followed.

And now there is new medical research which says HIV+ women should breastfeed their babies. Women who have a high CD4 count and a low viral load are encouraged to breastfeed. This has been news for the past year or so.

But here is the interesting part of the story: Doctors are now telling HIV+ women to breastfeed, but the women won't do it--at least the ones I know. They are not willing to take even the slightest risk of possibly infecting their child with HIV. In order to fully comprehend this, let me give some background on Nigerian culture:

A pregnant woman in Nigeria does not have to ask herself: will I breastfeed or bottlefeed? The thought never crosses her mind; of course she will breastfeed. When a woman with a small baby is not breastfeeding, it sends an immediate signal to everyone else that something is wrong with this woman. It's really quite devastating for a Nigerian mother to hear what is said about her when she doesn't breastfeed.

And this is why I'm a bit surprised that these HIV+ women won't breastfeed, especially now that they've been given a green light to do so.  In fact, they basically open themselves up to cultural ridicule. And besides that, baby formula is expensive ($7.50 for a 14 oz. can).  Why do they make this decision? They will do anything to give their child a fair chance in life. Many have already lost one child to HIV and simply aren't willing to take the risk on another child.