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A new hope
Publication Date : 06-12-2013
Medical programmes are helping HIV-infected women give birth to healthy babies
Holding her 1-year-old daughter in her arms, 20-year-old Xiao Mei is all smiles. The baby girl is the only child free from HIV/AIDS in her family of four in Zhumadian, Henan province, thanks to a government-subsidised programme that provides pregnant women with free treatment to block mother-to-child transmission. "I cannot express in words how happy I feel now," Xiao says. "I always wanted a baby, but was extremely worried that I would give HIV to the child."
Xiao was infected from a blood transfusion as a young child. Her husband, also 20, was born with HIV, and his father died from AIDS.
They enrolled in a local mother-to-child transmission block programme when they decided to have a child. Two HIV tests on the baby have both been negative.
Numerous families have benefited from such a programme.
China is estimated to have 780,000 people living with HIV/AIDS, among which the ratio of women jumped from 15.3 per cent in 1998 to 28.6 per cent in 2012, and most of them were of reproductive age, according to Guo Ruixiang, a China Programme Officer with UN Women.
Since Chinese health authorities issued guidelines to prevent mother-to-child transmission in 2001, many national and provincial programmes that provide free intervention have been initiated.
"In 2012, only 7.1 per cent of newborns born to HIV-positive women were confirmed to get HIV from their mothers, and roughly 4,500 children avoided getting HIV infection since 2001," says Wang Fang, an HIV/AIDS control specialist with the National Centre for Women and Children's Health.
"Without interventions to block the transmission, the ratio will be as high as to 34.8 per cent."
Although there are no statistics on provincial programmes, about 1,160 counties receive financial support from the central government to block mother-to-child transmission, according to Wang, whose institute, under the Chinese Centre for Disease Control and Prevention, is the main facility to provide technical guidance for the national programme.
With those widely launched programmes, HIV testing has become part of routine antenatal checks when mothers-to-be arrive at hospitals. The fathers are also advised to take the test. Many women and children's health hospitals provide free HIV testing to pregnant women, Wang says.
Antiretroviral therapy is provided for HIV-positive women before, during and after pregnancy, under the direction of professionals.
When it comes to delivery, doctors will weigh the choices of a C-section and natural birth, to ensure the greatest benefit for mother and child, without transmitting HIV from the mother to the baby.
They will also weigh the choice between breast-feeding and formula milk, because although breast-feeding can transmit the virus, formula milk might be unavailable to some people.
Free psychological consultations are also offered to HIV-positive pregnant women and mothers through the process. "All the medications and consultations are free," Wang says.
However, according to the National Health and Family Planning Commission, among the HIV/AIDS population of 780,000, only 56 per cent are aware of their status, and statistics from the National Centre for AIDS and Sexually Transmitted Diseases Control and Prevention showed only about 200,000 receive free antiretroviral therapy regularly.
For women under threat of HIV/AIDS, the situation is even worse.
Fewer than 30 per cent of all young women have comprehensive knowledge of HIV, and studies show young women (age 15-24) are twice as likely as young men to become infected with HIV, according to Guo Ruixiang.
A study by UNAIDS in 2009 even showed approximately one-third of newly infected women contracted the disease from their husbands, who were exposed to the virus by sexual relations with other men or prostitutes.
Another study in 2012 in five provinces of high prevalence showed 31.6 per cent of HIV-negative wives were forced into having sex with their HIV-positive husbands in the past year, and mostly, women have little say on using condoms, Guo notes.
What is worse, women living with HIV/AIDS may be unaware of their status, or lack knowledge and access to medical services.
Wang Fang says the ratio of newborns getting HIV from their HIV-positive mothers can be less than 2 per cent with medical intervention.
China currently achieves only 7.1 per cent, because there are still large numbers of women who are not diagnosed with HIV/AIDS until it's too late, mostly when they are in the later stages of pregnancy, are about to give birth, or have already delivered a child.
Xiao Mei, the HIV-positive woman in Henan province, says she dared not take HIV medications because of fear of social stigma. Her knowledge of HIV mainly came from her husband and mother-in-law after marriage.
"The female HIV/AIDS population is a neglected and silent group," Guo says.
"It is great that Chinese government and HIV/AIDS organisations are launching feasible programmes to better support the HIV population, but there is more to do for women living with HIV/AIDS."