months and $20 to get about six pages), all it said under family history was, "Mother is HIV-positive" in big bold letters. When my child got sick, I was afraid to take her in for care. Now that's a dangerous situation.
I was honest about the fact that I gave up trying to give my babies Septra. That's just the kind of person I am. Well, a lot of women called me to say that they had given up too, but that they had never shared this information with their pediatricians. I encouraged them to discuss it with their providers, but most are afraid.
What will happen to the babies that are positive whose mothers are afraid to have a frank discussion about compliance with their pediatricians? Missing a couple of doses of Septra is not a disaster, but with so few choices available to children with AIDS, missing a few doses of a triple drug combination that includes a protease inhibitor could wipe out their treatment options for life.
Pregnancy is an emotional time in a woman's life, a time of reflection, of learning to trust one's own body, and of having to trust one's inner voice. Regardless of HIV status, the choice to become pregnant is rarely a rational one. (The planet is not underpopulated. Few people suffer from too much free time or money. Morning sickness is not pleasant. Neither are diapers.) Women who choose to become pregnant or continue a pregnancy are usually acting mostly on their emotions, and they will pursue prenatal care and treatment decisions in the same way. I knew all the great facts about AZT's ability to reduce perinatal transmission, but I was afraid to take it until another woman with HIV told me how she did a blessing ritual with hers first. Hokey as it sounds, that worked for me.
If I had been forced to take AZT before I was ready, I likely would have gone running away from prenatal care rather than feel drawn to it. How many of you like to be told what to do? How many respond to orders with an urge to do just the opposite? I could be wrong, but I'm inclined to think that we should offer HIV testing to every woman who is pregnant. I also think that rather than forcing her to do it, we should focus our efforts and money on addressing the issues that will motivate women to want to get tested and get prenatal care. Then, hopefully, she'll be drawn to the benefits of trustworthy and qualified prenatal care, and the rewards that a respectful partnership between provider and patient can offer.
A poster I saw by the Pediatric AIDS Foundation provides a good example of this. It shows all kinds of beautiful babies and the text reads: "All healthy. All HIV free. It's amazing what a mother can do." It's positive, encouraging, respectful, and inspiring. When approached in this way, what woman wouldn't want to test?
In 1994 I enrolled in a study at the NIH [National Institutes of Health]. When I was told that my PCR test came back "undetectable" a whole world opened up for me. For years I had not dared to imagine a future beyond 6–12 months. When