Positive women positive lives

Positive women positive lives Alfred Thutloa Summary: In the developed world, HIV/AIDS has become another manageable disease and HIV-positive mothers hardly pass the virus to their babies. However, in the developing world where access to health care and treatment is poor, more babies are born with HIV than anywhere else in the world. There is a critical need for health education and psychosocial support for HIV-positive mothers. Introduction The rights of women have been a point of struggle and resistance for years. The sixties and seventies for example have been regarded as the rise of the women’s liberation movement, characterised by the nuanced burning of the bra in 1968 (Press of Atlantic City, 2010). The fight against HIV and AIDS has also become another fight for women particularly in Africa. Today, HIV and AIDS has become the leading cause of death in sub Saharan Africa, and infection rates among young women are three times higher than among young men (WHO, 2013). In addition many women only realise that they are HIV-positive when they are pregnant. This can be devastating news for a woman who is due to give birth as she fears for the life of her unborn baby. There is a need in public health care facilities for education and psychosocial support services for HIV-positive pregnant women. However before putting forward a case for such support, an overview of the state of the South African health care system is required. The unhealthy state of health care in South Africa The World Bank classifies South Africa as one of the four richest countries in Africa, along with Botswana, Gabon, and Mauritius, and over 16.7 billion of gross domestic product (also called GDP) is spent on health (Yach and Kistnasamy, 2007). Despite this large spending on health, the country’s health system performs badly when compared to other middle income and in some cases even lower income countries. The health care system is also terribly unbalanced with about 12% of the people accessing private health care and over 80% of the population using public health care (Gray, Vawda and Jack, 2011). Even though the public health system was restructured after 1994 and given more resources such as new or renovated facilities, these successes have been diluted by the burden of HIV and AIDS (Harrison, 2010). Additionally, overstressed public health workers were caught unprepared for the HIV pandemic and did not have the will and capacity to effectively support HIV-positive individuals, particularly HIV-positive mothers. This left a huge gap within the health system and meant these women could not receive the education and support they needed.

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How to support HIV-positive mothers HIV-positive women can give birth to HIV-negative children. The biggest challenge in helping these women especially those who use public health care services has been how to encourage them to use lifesaving treatment to reduce the risk of their babies contracting HIV. This type of service is rightfully called preventing mother-to-child transmission of HIV, shortened as PMTCT. There are a number of documented stories of HIV-positive mothers that have given birth to an HIV negative child. One South African non-profit organisation that is focused on providing education and support to HIV-positive mothers is called mothers2mothers. They mention that they have more than 200 000 pregnant women and new mothers living with HIV who they have enrolled into their mentor mother programme. Their mentor mother PMTCT programme is based on employing HIV-positive mothers who the organisation has trained in health education and how to provide psychosocial support to other HIV-positive mothers. This model of care, they claim has been highly effective that many women who have been through their programme have given birth to HIV-negative babies. Fostering a culture of support and non-discrimination The most cited challenge of dealing with HIV and AIDS among HIV-positive mothers is not unique to the broader issues around HIV and AIDS, which include lack of HIV education, testing and treatment. Due to the stigma surrounding this disease, many HIV-positive mothers only discover their status while pregnant and in a lot of cases they fail to access treatment to reduce the risk of their babies contracting HIV. Doctor Mitchelle Besser who is the Founder and Medical Director of mothers2mothers agrees when he says: “in resource-rich countries … 98 percent of babies are born HIV-negative. Yet, in resource-poor countries, in the absence of tests and treatment, 40 percent of children are infected.” Another challenge that faces these mothers is their ability to make the best feeding choices for their newborns. For example some mothers are afraid that if they opt to feed their infants’ formula milk instead of breast milk, that their community will immediately question their HIV status. However recent research from South Africa shows that exclusive breast feeding coupled with antiretroviral treatment can significantly reduce the risk of mother-to-child transmission of HIV (WHO, 2010). Conclusion The South African health care system faces huge challenges in providing health education and support services to HIV-positive mothers. Health policy makers and health implementers need to consider that one of the solutions towards an HIV free generation are health education and support services that empower HIV-positive mothers to prevent their babies from contracting HIV. Current services need to be strengthened and innovative models of care have to be created that address the needs of HIV-positive mothers.

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Notes: The author’s experience with working with HIV-positive mothers was based on site visits to peer support groups attended by HIV-positive mothers through the mothers2mothers mentor programme. The author did not want to make particular reference to any of the sessions he attended but has based some of the statements made in this article on testimonies and narratives from the HIV-positive mothers he met.

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