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Monday 26 May 2008

When the children get infected

I was reading MarinaM’s posting about a wedding of a HIV+ couple and also about another HIV+ couple (who got married after knowing about each other's HIV status) she met at the wedding. The second couple is expecting a baby soon.

Now, before some of you start thinking that the second couple are being selfish and are not thinking about the risks of passing the virus to the baby, please note that their good doctor had informed them that their viral loads are undetectable (they are on antiretroviral medication) and as such the risk of passing the virus to the child is somewhat minimized. Of course, they still have to make sure that all other measures are taken (other than the mother taking ARV, delivery will have to be by caesarian section and she must not breastfeed the baby).

Ahah, that being the case, why was I so worried about Yah and Mr Darling, both of whom are positive? Well, I don’t know Mr Darling personally, but based on whatever was going on between him and Yah and not forgetting his ex-wife, Lin, all he was thinking about was having sex! Yah on the other hand, ever since the angau bug bit her, can’t seem to get the romeo out of her mind - I’m not surprised if she’s not taking her medication regularly. My fears were confirmed when SN told me that Yah’s CD4 count dropped tremendously while her viral load count was very high! Many of my clients don’t seem to see the importance of being compliant in taking their medication no matter how “berbuih mulut” SN explaining to them from A to Z.

Anyway, from the group of HIV positive women under my care, 5 of them found out about their HIV infection when they were pregnant. It was also then that they found out about their husbands’ (or ex-husbands’) HIV status.

Zainab, Maria, Fuzi, Yah and Sha all took the necessary measures to minimize the risks of their babies getting infected. Sha did think about abortion the moment she found out she was HIV positive, (she thought the virus would surely infect the baby if she continued with her pregnancy) but upon advice from the doctor, and after consulting her HIV-negative husband (she got HIV from her first husband), she went on with the pregnancy.

The children of all 5 ladies are now over 2 years old and have been safely confirmed as free from the virus.

Then there was Zana, the problematic young woman who got pregnant out of wedlock and hid her pregnancy, even from the doctors! By the time I found out, she was almost 7 months pregnant (and yet it didn’t show) and I had to immediately arrange for her to meet the doctor again despite her last appointment being just the week before. She was immediately given ARV medication and arrangement was also immediately done for her to see a gynae. She safely delivered twins, but one of the twins died last year, not due to HIV but due to other complications.

Imagine if Zana simply ran away to avoid people from knowing about her pregnancy, and ended up delivering the babies without proper checkup until it was time to deliver, chances were that she would have gone through normal delivery and the babies would have been infected. Thank goodness she was desperate to find a shelter home so she finally confided in me.

So yes, from the 6 pregnant HIV+ women assigned to me, all of them delivered HIV-free babies. You see, the risk of the virus being passed on to the baby is highest during delivery, not during pregnancy… thus, the need for c-sect.

Aha, but I have mentioned about a few HIV positive children in my previous postings, haven’t I?

I don’t know when hospitals started screening pregnant women for HIV, but the 4 HIV infected children that I personally know, are all aged 6 years and above. The eldest is Pushpa (one of the recipients for our sponsorship programme), 13, whose parents died when she was small. Nuri’s daughter, Fara, is 8 while the other 2 kids – the late Lily’s son, Boboy, and Fuzi’s son, Ijam – are both 6 years old.

My guess is, 6 years ago pregnant ladies were not screened for HIV.

So, what happens if the children are infected? Ahh… medication all their life - unless of course one fine day a cure is found. What about the stigma and discrimination they may have to face? Well, in most cases, the fact that they are infected is kept a secret. In Fara’s case, when initially she used to get sick, the school authorities only knew that she had some lung infection.

Is there a chance that even if the school authorities knew, the children will not have to face stigma and discrimination? Maybe, although I doubt it, really. While some may sympathize and empathize, there are bound to be one or two kay-poh ones! When Lily’s children submitted their father’s death cert (indicating he died of HIV) to the school to apply for financial assistance, one of the teachers kept pressuring Lily to provide proof that her 3 daughters at the school were indeed not infected. Things were even worse for Boboy, her infected son, whose kindergarten teacher kept telling him he need not come to school after she found out about Boboy’s HIV status. Oh, the poor child…

So folks, if one fine day you do happen to get to know of any HIV positive child, give the child a hug, will you?

9 comments:

Kerp (Ph.D) said...

yo!

hey, i never knew this. so if both the couple are HIV+, they can still lead a normal marriage life. provided ofcourse, the wife forgives the hubby for the sin he committed before. to have a new bundle of joy at home can in fact play a major role in patching up all the cracks and can always be the reason for them to start life anew. good to know.

and for a couple who do not wish to have a kid, the man must learn the proper way in putting on the condom. right or not kak Pi?

elara said...

I have never been in contact with HIV patients and makes me wonder what is it like to be in your shoes Puan Pi. You tackle problems with commendable zeals helping them all you can. Tuhan sajalah yg dpt membalas jasa Puan. Keep up the good work. InsyaAllah I will hug a HIV+ boy if i ever come across one though I am ambivalent about them.

Pi Bani said...

Kerp,
The important thing is that the PWHAs must take care of themselves, be compliant with their medication etc. Otherwise, if their CD4 keeps going down and their viral loads keep going up, then don't even think of having a baby la!

As for the condom, now, now... it's not just a matter of putting it on, must also remember to take it off the safe way... jangan tumpah naaa... :)

Pi Bani said...

Elara,
Before getting involved with Buddies, I never knew how it felt either. Now that I'm involved, rasa biasa je. They are after all, just humans, kan?

Kerp (Ph.D) said...
This comment has been removed by the author.
Kerp (Ph.D) said...

agreed!

and like elara, i'm pledging the same, to hug any PLHWAs that comes my way. i might be accused of molest, so i'll hug the guys instead. yup! rying to shed this very bad homophobic image of meself.

Pi Bani said...

Kerp,
Just don't go around hugging every guy you meet, ok? ;)

Lee said...

Hi Pi Bani, reading your this post, you macham doktor. You are very good with your hands on knowledge of this HIV problems and people involved.
I guess HIV like lepersy....can't spell the word, ha ha.
One time orang takut go to Sungei Buluh area where the institution grow plants and sell them. But I after hearing my doctor friend said no problems went to get my plants there very cheap.
But never told my friends where I got them.
Gosh, I read in your comment below re condoms and taking it out the proper way...Holy Smoke! You sure know your stuff, Pi Bani, *wink*.
No la, I won't start another condom cherita.
Pi Bani, like I mentioned twice before, women like you don't grow on trees...
and Kerp buat saya ketawa, you too, about hugging guys, I never hug guys, shake hands sahaja, but women, ahhh, itu lain cherita, ha ha. Lee.

Pi Bani said...

Hi Lee,
Ya la... last time people were so scared to go to Sg Buloh.

Me macam doctor? If I doctor many patients mati already la!

And of course women like me don't grow on trees. I'd run for my life if I see any woman growing on any trees! Could be a pontianak for all I know... CABUUUUUTT!!