What Will I Tell the Child?

Considerable progress has been made in the battle against HIV/AIDS since it first appeared on the world stage in the early 1980s. It is no longer stigmatized as a “gay” disease, funding for medical research is way up, and modern treatment essentially allows people with HIV to live manageable lives – as we see, for example, in the well-known case of the former NBA player Irvin “Magic” Johnson.

However, there remains one tragic aspect of HIV/AIDS that is still not fully appreciated: the impact on a mother who gives birth to an HIV-positive child. In other words, the giver of life, during pregnancy or childbirth, delivers a lifelong sentence of disease to her child that often results in the child’s death – in front of the mother’s eyes.

This is especially the case in developing countries. While it is generally known that HIV is transmitted through sexual contact and blood-to-blood transfer, less known is the fact that  mother-to-child transmission (MTCT) is how 90% of children get HIV and the 3d most common way globally that HIV is transmitted.

Understandably, the first one to be told that the child has HIV is the mother. As a study conducted by  the Harvard Medical School and colleagues points out, this places a tremendous burden on her to disclose: first to her spouse and then, eventually, to the child. Disclosing their status was often very difficult for women, who feared that their partners would blame and/or abandon them upon hearing the news.

Explaining antiretroviral use to children was cited as a challenge to long-term care of HIV-positive children. Parents generally did not tell their child why they were giving them medicine, but some children started to inquire. As an HIV-positive mother put it:

The thing that disturbs me is that I always think what will I tell my child when he grows to a level of understanding and he asks me why he is taking drugs. Because even now he asks me, ‘Mummy I no longer cough but why am I still taking drugs every day?’ What will I tell the child?

As the Harvard et al. study tells us, motherhood places particular stress on HIV-infected women due to higher levels of depression, poorer family cohesion, less ability to perform daily functions, and the need to care for HIV-infected children.  One serious effect of depression and anxiety is on patient adherence to (lifesaving) medication regimes: i.e. depressed patients had three times the odds of noncompliance compared to non-depressed patients.

But there is a way to avoid these problems: treatment of the mother before she gives birth. Pathogens that are passed on during labor are usually found colonizing the birth canal. Vitalwave treatment targets these pathogens, destroying them safely and effectively and thus prevents the transmission of HIV to the child in the first place.

So in answer to the mother’s question, What will I tell the child? what do we say to her, knowing that if she were properly treated before she gave birth, the question wouldn’t have arisen in the first place?

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