Mothers with AIDS experiences a dilemma

CYNTHIA , a woman who lives in the West Indies, had the opportunity to breastfeed or bottle her newborn. The decision may seem easy. After all, health experts have been promoting breast milk as the “best healthy food” for babies for decades. In addition, bottle-fed babies in poor communities are around 15 times more likely to die of diarrhea than breast-fed babies. In fact, the United Nations Children's Fund (UNICEF) reports that around 4,000 children die every day from the dangers associated with breast milk substitutes.

With Cynthia, however, the decision to breastfeed was another danger. Her husband infected her with the human immunodeficiency virus (HIV), which causes AIDS. After delivery, Cynthia learned that a child born to an HIV positive mother had a 1 in 7 chance of being infected with breast milk. So you had to make an agonizing decision: expose your baby to the risks of breastfeeding. feed it or expose it to the dangers of the bottle.

In areas of the world most affected by the AIDS epidemic, 2 to 3 in 10 pregnant women are HIV positive. In one country, more than half of all pregnant women tested were infected. "These alarming numbers," reports UN radio, "have led scientists to find a cure." To respond to this threat, six United Nations agencies have combined their experience, efforts and resources to form the joint United Nations program on HIV / AIDS known as UNAIDS. * However, UNAIDS found that solving the AIDS dilemma is not that simple.

Complex obstacles block a simple solution

According to Edith White, a specialist in breastfeeding and vertical HIV transmission, health professionals advise HIV-positive women in developed countries not to breastfeed their babies, as it nearly doubles the risk of childbirth. infected. Using infant formula seems like a logical alternative. In the developing world, where idealistic theories are quickly giving way to difficult realities, this simple solution is difficult to find.

One of the obstacles is the social. In countries where breastfeeding is the norm, women who fill their babies can report they are infected with HIV. The woman may fear being guilty, abandoned, or even beaten if her condition is known. Some women in this situation feel like they have no choice but to breastfeed their babies in order to keep their HIV status a secret.

There are other obstacles as well. Take Margaret, 20, as an example. Like at least 95% of women in villages in Uganda, she has never been tested for HIV. But Margaret has cause for concern. Your first child is dead and the second is fragile and sick. Margaret breastfeeds her third child ten times a day, even though she is HIV positive. "I could never give my baby food," she says. Why not? According to Margaret, the cost of feeding baby food is one and a half times what a family in their village earns in an entire year. Even if the formula were available for free, there would still be a problem finding clean water to turn the formula into child-safe food. * *

Some of these barriers can be overcome if HIV-infected mothers are provided with adequate sanitation, adequate amounts of breast milk substitutes, and access to clean water. Expensive? Perhaps. Surprisingly, however, it appears to be a matter of prioritization rather than finding funding to make such arrangements. In fact, the United Nations reports that some of the world's poorest developing countries spend about twice as much on the armed forces as they do on health and education.

What about AIDS drugs?

UN scientists have reported that a simple, relatively cheap drug called AZT can drastically reduce the transmission of HIV from mother to child. With the help of UNAIDS, the cost of this treatment has been reduced to US $ 50. In addition, AIDS researchers announced in July 1999 that treating HIV-positive mothers and their newborns with just $ 3 of the drug nevirapine appeared to be even more effective. as AZT in preventing HIV transmission. According to health experts, nevirapine can prevent up to 400,000 newborns each year from starting an HIV-infected life.

However, some criticize these drug treatments, claiming that since the mother limits herself to preventing the transmission of HIV from mother to child, she will eventually succumb to AIDS and leave the child orphaned. The UN replies that the darkest alternative is to allow babies to become infected with HIV and to condemn these innocent victims to a slow and sad death. They also claim that mothers with HIV can live for years. Look at Cynthia mentioned above. She discovered that she had HIV when her baby was born in 1985, but she didn't get sick until eight years later. And although her baby was born with HIV, it wasn't anymore when she was two.