HIV campaign among women vital

By Stevie Emilia

JAKARTA (JP): All mothers would be devastated to hear their babies have tested positive for the Human Immunodeficiency Virus (HIV), especially if their children contracted the virus which leads to AIDS from them.

Mother-to-child transmission of HIV is commonplace in developing countries, including Indonesia. It is estimated that this route of transmission accounts for 5 percent to 10 percent of total new infections each year in developing countries.

It covers 14 percent to 42 percent of the total number of infections in different regions. European countries have the lowest rate of mother-to-child HIV transmission at 14 percent, and the United States and Thailand both have 25 percent. Africa has the highest rate.

In Indonesia, the government reports there are six HIV- positive babies, with the first recorded in 1996. Experts warn the actual figures may be significantly higher.

Samsuridjal Djauzi of Pelita Ilmu Foundation, a non- governmental organization on AIDS prevention, said the real figures was likely to be higher because 293 out of 839 people with HIV/AIDS reported up to February this year were women in their reproductive years.

Pelita Ilmu, he said, was in touch with 10 expectant mothers with HIV.

"I suspect there's not many expectant mothers who are seeking consultation on their pregnancies," Samsuridjal said. "Even worse, many of them are afraid to undergo testing and counseling."

With sophisticated tests, the HIV status of a fetus can be identified in one or two weeks.

He underlined the need to inform the public that pregnant women from high-risk groups should undergo HIV testing -- and receive counseling if they are positive.

Apart from the lack of information, many Indonesian women, like their counterparts in other developing countries, also do not have access to testing and counseling services, he added.

"Besides, the cost of HIV testing is still considered too high."

The test and counseling cost about Rp 50,000.

Many NGOs, including Pelita Ilmu, have assisted with free testing and counseling in some of their campaign activities. It remains limited.

Samsuridjal said research showed mother-to-child transmission of HIV -- which mostly occurs prenatally at the time of labor but can occur after birth -- was preventable.

"Intervention which has proved useful to reduce mother-to- child transmission significantly includes the use of antiretroviral (drugs), no breast-feeding or performing caesareans for delivery," he said.

In developed countries, he said, the measures have been implemented with satisfactory results. In the U.S., according to the UNAIDS, the rate of mother-to-child transmission HIV was reduced to 500 babies annually in 1997.

In developing countries such as Indonesia, the measures are difficult to implement.

According to Samsuridjal, the main obstacle is the assumption of many expectant mothers that HIV cannot touch their lives.

"Many still think that HIV will only affect certain groups, like sex workers, homosexuals and unfaithful housewives. That perception makes expectant mothers' awareness of the danger of HIV infection very low."

Husbands sometimes bar their pregnant wives from finding out their HIV status.

He said counseling allowed prospective mothers to gain the right information on HIV and AIDS, and judge whether she or her husband was engaged in high-risk behavior.

"After counseling, she can decide whether she needs to undergo HIV testing or not."

In support of its programs to prevent prenatal transmission of HIV and to provide counseling on the deadly disease, Pelita Ilmu received a US$30,000 health care grant from manufacturer and supplier of medical devices and diagnostic systems, Becton Dickinson and Company.

The grant was presented by president of Becton Asia Pacific region, Eugenio Naschold, to the foundation's chairman Zubairi Djoerban on Tuesday.

According to Zubairi, the funding will be used to inform, counsel and test 1,000 expectant mothers in Jakarta.

"We will provide support to those women who are HIV positive and prevent prenatal transmission by providing AZT tablets. We also will educate health care workers ..."

Samsuridjal said the foundation would assist expecting HIV- positive women by providing them with five 100 mg capsules of AZT a day for four weeks before giving birth.

"But when they are about to give birth, we will increase the dose to suppress HIV. At that time, the expectant mothers should take 300 milligrams of AZT every three hours," he said.

A box of 100 capsules of 100 mg of AZT, he said, sold for about Rp 500,000.

"Apart from assisting the mothers, the foundation will provide artificial milk for the child for a year as breast-feeding can transmit the virus," Samsuridjal said.