HIV Positive Mothers Defy Death Sentence

Martina Edwards is every inch a trendy lady. Averagely sized, glowing skin colour and texture, simply but beautifully dressed with an elegant hair-do to match.

The beam of charming smile that reverberated from her cheeks during the exchange of pleasantry and her mien during the entire duration of an interview she granted this reporter gives a truly positive impression of a young lady who has got life going the way she desired. At least, she’s married and blessed with two beautiful kids (although her physique does not say so), working in a reputable financial institution and enjoying every bit of love from her husband, family and friends.

Martina tells an ironical story of a woman that has chosen to live despite being told, she could live for only three years, by doctors in 1996 after testing positive to HIV.

Martina, while relating her miraculous life story during an interview in Port Harcourt, South-South, Nigeria, (where she resides with her husband and children) said, "I woke up one day when I was still in my first year in the university with no feeling that anything was wrong with me until one of my roommates pointed out a swell on my neck to me. I couldn’t imagine what the cause of the bulge was and so had to go to the clinic."At the clinic, several tests were run on her including for HIV to which she tested positive. For Martina, the world seized to be a place at that moment, this was later confirmed by the doctors as she narrates: "Then, the knowledge people have now of HIV/AIDS was not the case. The doctors told me I could only live for three years afterwards." She had no reason to doubt the test because it was carried in a reputable clinic run by one of the oil majors. She also went ahead to repeat the test followed by series of confirmatory tests that did not change the story.

With this death sentence hanging on her head, she decided to bury her head in her books, while death comes.

But the three years came and went and she still felt as healthy as she used to. After graduating with flying colours from the University, she was posted to Abia State, South Eastern Nigeria, to observe the mandatory National Youth Service Corps (NYSC). It was during the orientation camp for NYSC that she met her husband, Edwards. Then, Edwards was about rounding off his NYSC in the same state.

"When he met me, he was a very strong Christian. I didn’t hide my status from him, but he was not deterred. He went ahead to put up a marriage proposal to me. I really found this strange, but he was unshaken," Martina said.

With soothing words and counsels from Edwards, Martina got a psychological relief. Edwards gives her more than a reason to cheer up, and at this point the death sentence toga was started to wear-off.

They went ahead to get married after the NYSC programme. But she had another worry hanging over her head. The doctors had told her that she would not be able to give birth to healthy babies and that if she dared to, the babies would only live for a short period. But at this point, her knowledge on HIV had grown.

"I read books and literatures about HIV and was able to understand that being HIV positive is not an automatic death sentence, not even for unborn babies anymore," Martina said.

Mother luck smiled on her soon after wedding. She became pregnant. But this was almost marred by what followed.

"I became very ill during my first pregnancy that at a point the doctors were confused on what to do. They said my viral load has shot up and drugs administration was the least option to avoid any damage to the unborn child."

The husband had to undergo testing to be sure of his status. He was negative. But the result did not elicit extra excitement from the husband, as he had, prior to the test, made up his mind to brace whatever the outcome would be.

Fortunately for Martina, knowledge on Prevention Of Mother-To-Child Transmission of HIV (PMTCT) had improved among health providers at the Braithwaithe Memorial Specialist Hospital (BMSH), Port Harcourt, where she was attending Antenatal Clinic. She was able to manage the crisis that trailed that pregnancy and gave birth to a beautiful baby girl. The best news came later. The baby was tested and found to be HIV negative.

Because her viral load peaked during pregnancy, she was advised not to breastfeed the baby. This, she adhered to religiously, with the encouragement from her husband. 14 weeks ago, the Edwards were delivered of another beautiful baby girl, who is also HIV negative.

"I think I am the luckiest person on earth. My two kids are HIV negative, despite my being positive. I have a good job, I hardly fall ill and to cap it all, I have a husband that is all that a woman would want," Martina said.

Martina has gotten over the pains of being HIV positive. She now think and feel like a normal woman. She even said she wants two more children. Her confidence has been buoyed by the improved knowledge on how mothers could avoid transmitting the virus to their children with help from medical experts.

Martina’s case is similar to that of 21-year old Linda Ikechukwu. She is an HIV positive mother of a three months old baby girl. She spoke to this reporter shortly after receiving the result that confirmed the baby HIV negative at the Braithwaithe Memorial Specialist Hospital, Port Harcourt.

She tested positive to HIV in 2007. Although she was initially baffled at the result, she said it would have been through a blood transfusion she had in a private hospital at Aba when she had aneamia from Malaria. Just like Martina, she disclosed this to her partner. "We were initially sad about the test, but he thought it was not a death sentence. So, we continued our relationship," said Linda, who became pregnant afterwards. "While I was pregnant, I started my Antenatal Clinics, during which I was thought how to avoid infecting my baby, especially after birth. I am happy that it paid off. My baby is HIV negative," she said.

Mrs. Vivian Martyns is Rivers State Coordinator of Prevention of Mother-To-Child Transmission of HIV programme.

Awareness on PMTCT has grown remarkably among mothers and healthcare providers in the state in the last one year, according to her.

She attributed this significant improvement to the series of UNICEF supported trainings that have been offered to the healthcare providers, especially those who attend to women.

"We have PMTCT services in all Local Government Areas in Rivers State. This has been facilitated with the help of UNICEF," Martyns said. She, however, noted that awareness on PMTCT in the state is still low.

"The people still harbour fears about HIV/AIDS, which makes it a bit difficult to get them to access PMTCT services. Most times, if they discover that they are HIV positive, they stay away from the hospital until they are ready to deliver," Martyns said. She also attributed the difficult in getting more mothers in the state to access to the ‘changing face’ of the state.

"Most of the people, especially females that are in Rivers State are not permanently resident in the state. Some of the females that test positive are likely to leave the state for another because some of them come here (Rivers State) for business, job or other reason. These groups of people are usually hard to follow-up with PMTCT," Martyns said.

Martyns said females account for 60 percent of HIV positive cases among discordant couples in Rivers State. This, she said is more related to the fact that the men have refused to present themselves for testing, even if their wives tested positive. Secretary, Rivers State Action Committee on HIV/AIDS (RIVSACA), Dr. Chimezie Okeh, also thinks that the state is making progress on PMTCT. In an interview in Port Harcourt, Okeh, said, "The government has shown that it is willing to offer political support for activities to reduce the burden of HIV/AIDS on the state. This is seen in the areas of training, infrastructure and other logistics."

He, however, admitted that more needed to be done to take PMTCT services beyond the level it is now in the country.

Similarly, Paediatrician at Braithwaithe Memorial Specialist Hospital, Dr. Jibola Alabi, noted that the biggest challenge for the hospital on PMTCT is getting the HIV positive to follow up their Antenatal clinics and getting them to deliver at the Hospital. "Most times, if these women discover that they are HIV positive, they stay away from the hospital" Alabi said.

"They either go somewhere else to deliver or chose to go the Traditional Birth Attendants. If they stay with us here we will employ prophylactic measures to prevent the baby from getting infected and advise them accordingly on feeding options."

UNICEF, riding on the Rivers State’s Action Committee on AIDS (RIVSACA), has gone ahead to incorporate trainings for community mobilisation officers who carry their acquired PMTCT expertise further to the grass roots. Mrs. Uloma Okere is the PMTCT Community Mobilisation Officer at Omuma Local Area in Rivers State. She works directly with the Local Action Committee on AIDS (LACA) of the LGA. "We have done well to ensure that the women in community accept and access PMTCT services. This has worked for us," Okere said.

Omuma, hitherto, revelled in the nil HIV prevalence it was designated in a 2005 sentinel survey of the area. But recent discoveries have found that 5.1 per cent of the people are HIV positive.

"Increase in awareness on PMTCT has resulted in more women coming for Antenatal clinic. This, coupled with the existence of Tuberculosis and Leprosy unit at the health clinic, has made us realise that there are more HIV positive people in Omuma than earlier thought," she said. Rivers State accounts for 3.58 percent of Nigeria’s population. Previous HIV Sentinel surveys show that the prevalence rate in Rivers state dropped from 7.7 percent in 2001 to 5.4 percent in 2005. Meanwhile, more cases of mother to child transmission of the virus are being observed across the country.

According to United Nations Joint Programmes on AIDS (UNAID), prevention of HIV transmission from mother to her baby while in the womb or during birth or infant feeding requires a comprehensive package of services that includes preventing primary HIV infection in women, preventing unintended pregnancies in women living with HIV, preventing transmission from pregnant women living with HIV to their infants, and providing care, treatment and support for women living with HIV and their families.

It recommends that health systems should be strengthened so that interventions to prevent mother to child transmission of HIV infection, including the use of antiretroviral drugs, can be safely and effectively implemented. Buttressing this, Martyns said HIV testing in pregnancy has a number of benefits in terms of prevention and care for mother and child.

"This will afford mothers the opportunity of timely intervention that will prevent her child from being infected. Antiretroviral drugs administered to HIV-diagnosed pregnant woman and her newborn significantly reduces the risk of mother-to-child HIV transmission," She said.