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Reducing the Odds Preventing Perinatal Transmission of HIV in the United States (1999) / Chapter Skim
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I HIV Testing and Perinatal Transmission: Thoughts from an HIV-Positive Mother
Pages 275-285

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From page 275...
... I hope that what I share here can help us all focus on how we can improve the health and welfare of HIV-positive women and their babies. The Case for Universal Testing Every pregnant woman should be offered an HIV test.
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From page 276...
... If the majority of women are going to agree to be tested, isn't it better that the woman and doctor work together as a team? In my opinion, universal offering of voluntary testing is the best way to identify infected mothers and at-risk babies while enhancing the woman's trust in the medical provider and system.
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From page 277...
... If the woman begins to use drugs and avoids prenatal care altogether, how will this affect the fetus? · Some fear violence, rejection or abandonment by a partner or family members if their HIV status is discovered (which it likely would be if she started taking AZT five times a day)
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From page 278...
... The viral load count of 100 that was reported by the lab may be a false positive, or it may not. Because of her doctor's lack of experience and knowledge, she has either gone through an unnecessary scare, or lost valuable time in which she could have had the option of intervening with a combination of antiviral drugs.
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From page 279...
... Here we have a program that we know works, that we know saves lives, that we know has reduced transmission rates to nearly zero, and yet they struggle for funding and staffing. If the real goal is saving lives, then regional centers such as BAPAC need to be adequately funded and staffed, to provide direct services to HIV-positive pregnant women, and to provide training and consultation to providers of women who choose to stay with their regular obstetrician or perinatologist.
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From page 280...
... One study presented at the National Women and AIDS Conference in May showed that Viracept reduced certain hormones found in birth control pills. Does this mean we may begin to see unplanned pregnancies in women taking Viracept who use the pill for contraception?
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From page 281...
... Preventing Perinatal Infection Should Begin by Preventing HIV in Women Most pregnant women are infected by men, yet there is very little social marketing that clearly tells men who have sex with women that condoms are their responsibility. Most prevention programs, posters, brochures, etc., tell women to "make" men use condoms.
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From page 282...
... This woman had a substance abuse problem, no money, no place to stay, and social workers who regarded her as an unfit mother, but she was willing to do whatever it took to protect her baby from being born infected. Other Services Must Be Included in the Strategy to Reduce Perinatal Transmission Substance abuse is one of the main factors in women avoiding prenatal care.
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From page 283...
... I went eagerly to every prenatal appointment, despite tremendous inconvenience and having to travel from another city, because of my trust in my providers, and because of the respect I felt from them. Rather than treat me as a potential vector or threat to my unborn child, they treated me as a woman with the power to protect my child.
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From page 284...
... 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.
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From page 285...
... So please, let's remember as we all work so hard to protect babies from being born with HIV, to work equally hard for the health of their mothers, so we can be there for them, care for them, and see them grow up. Thank you for letting me share my thoughts with you today.
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Key Terms

  • pregnant women
  • viral load
  • save lives
  • hiv status
  • perinatal transmission

  • tested positive
  • specialty care
  • positive women
  • medical providers
  • mandatory testing

  • medical provider
  • voluntary testing
  • universal offering
  • women taking
  • medical appointments

  • child care
  • pregnant woman
  • treatment choices
  • drug combination
  • dna pcr

  • seek prenatal
  • adequately funded
  • reduce perinatal
  • care altogether
  • unplanned pregnancies

  • universal testing
  • substance abuse
  • undetectable viral
  • hiv testing
  • avoiding prenatal


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