HIV/AIDS: Preventing Mother-to-Child Transmission

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More than ninety per cent of children under the age of 15 with HIV/AIDS contracted the virus through mother-to-child transmission. Although the virus is transmitted by the mother, HIV/AIDS prevention is the responsibility of both men and women. Many mothers unknowingly pass along the virus from their husbands to their newborn children.

The following script aims to raise awareness about how HIV/AIDS is transmitted to children, and to provide information about prevention. It is also meant to encourage parents to overcome taboos about discussing sexual practices, and to take advantage of HIV/AIDS counselling and testing programs.

The script is in three parts. Each demonstrates a different aspect of prevention. The third part discusses treating AIDS with antiretroviral drugs. Before using part three, find out if these drugs are available to your listeners. If they are not, you may wish to develop a different program that alerts listeners to the benefits of these drugs, and helps them find ways to press for government support for this kind of treatment

Script

Part One

Characters:

Host

Mr. X:
man living with AIDS

Host:
Good [morning/afternoon], and welcome. Today, as part of our continuing series about children’s issues, we are going to discuss a difficult and sad topic: children who have AIDS, or who are HIV-positive. For those of you who are unfamiliar with these names, let me explain.

HIV is a virus that is spread by sexual contact with an infected person, by sharing needles or syringes with someone who is infected, or through transfusions of infected blood. Babies born to HIV-infected women may become infected before or during birth, or through breast-feeding. HIV attacks the body’s immune system. It weakens the body’s ability to fight off infection. If left untreated, HIV will eventually weaken the immune system so much that the person will become sick from certain types of infections. A person who has this virus is HIV-positive. A person is said to have AIDS when he or she gets sick from these infections. It might take a long time to develop the infections and therefore AIDS. In fact, someone who is HIV-positive can look and feel perfectly healthy for many years — as long as ten years. Without testing, they won’t know that they have the virus, and they can unknowingly infect other people.

Today we have a guest on our program who has AIDS. Before he knew he had the disease, he infected other people. He has asked that his real name not be revealed, to protect his identity. I’ll call him Mr. X. Welcome, Mr. X.

Mr. X:
Thank you.

Host:
Tell us what happened to you and why you want to share your story with us today.

Mr. X:
My daughter was born three years ago. She had the most beautiful eyes and dimples just like her mother. But she was infected with HIV at birth. Last year she died and I am heartbroken. My wife passed the disease to her. But I am responsible for this tragedy.

Host:
Why do you feel responsible?

Mr. X:
I don’t work here in the village, so I am away from my wife a lot. Like most men, I miss my wife, and so I meet other women. But I have been careless, and selfish. I don’t like to use a condom. So I had unprotected sex with these women — even with prostitutes, even when I knew there was a risk. A few years ago, I started to get sick. I was too proud and afraid to get tested for HIV. And still I stayed with my wife, and even other women. I suppose I figured that was one way to know.

Host:
One way to know what?

Mr. X:
I would know I had AIDS if my wife got sick. But she didn’t. In fact, she gave me my beautiful daughter.

Host:
And then tragedy struck.

Mr. X:
Yes. My beautiful daughter was born with AIDS. I watched her suffer. It was unbearable. [Coughs] Now, I am sick. I need my wife to care for me, but she is sick too — and she blames me for our misery. If I could turn back time…

Host:
If you could, what would you do differently?

Mr. X:
For a start, I would wear a condom while having sex. It is the first and easiest step in preventing the spread of HIV. And I would go for testing. If my wife and I had known that we were HIV-positive, we could have taken steps to prevent our baby from becoming infected.

Host:
What advice would you give to other men out there who may be having unprotected sex?

Mr. X:
Think! Think of your health. Protect yourself. Don’t have unprotected sex. Always wear a condom… especially when having sex outside of your marriage. No one wants to become infected with HIV. (Pause) And think about others. Think about your wife. Think about the beauty and innocence of a child and how tragic it is to see your child wither and die because of your carelessness and selfishness.

Host:
Thank you for your advice, Mr. X, and for your honesty. This is a very difficult subject to talk about, but if we want to stop HIV and AIDS — and especially, protect our children from it — then we must begin to talk about it, and take responsibility.

Mr. X:
You are right. If others can be spared suffering like my family, it is worth being a little uncomfortable.

Host:
Thank you Mr. X for being here today. As Mr. X has shown us, honesty and safe sexual practices are the first step towards preventing HIV infection in children.

MUSIC TO END SCENE


Part Two

Characters:

Host

Sheena and Asan:
a young couple about to start a family

Host:
Welcome back. If you are just joining us, we are discussing how to prevent HIV/AIDS transmission from parents to their children. We’ve just heard the story of Mr. X, who is responsible for infecting his wife and child. Now we will hear from a young couple, Sheena and Asan, who want to start a family and are worried about infecting their future child with HIV. Good afternoon.

Sheena and Asan:
[in unison] Good afternoon.

Host:
First of all, why are you worried about infecting your child with HIV?

Asan:
We know families with children who are living with HIV or who have died from AIDS. We don’t want that to happen to us.

Sheena:
And Asan was with other girls before we were married, without protection, so he could be infected.

Host:
What are you doing to prevent your future child from infection?:

Sheena:
We have been truthful with each other because we know that the health of our baby depends on us. We both decided to get tested before we conceive a child, to find out if either of us is infected with HIV.

Host:
Where did you get tested?

Asan:
The clinic offers confidential testing, so we went there together.

Host:
How do you feel about your plan, Sheena?

Sheena:
To be honest, I’m a little scared. We began counselling before getting tested. It would be devastating to find out that one or both of us has HIV, but it’s better to know before I get pregnant. That way, we will know if we have to take care to prevent transmitting it to our baby. (Pause) Or decide not to have children at all.

Host:
Our listeners should know that if a woman is HIV-positive, there is a way to reduce the chance that her unborn baby will be infected with HIV. We’ll hear about that in just a few minutes. But first, I want to thank you, Sheena and Asan, for coming here today. I applaud your honesty and responsibility in planning your family.

Asan:
We just hope that we are safe and can have a healthy child.

Host:
Good luck, and thank you.

MUSIC TO END SCENE

Host:
It’s often not easy to talk about sex, and especially HIV and AIDS. But it is important to learn about preventing children from becoming infected. Bringing a child into the world should be a beautiful event. Don’t risk losing your child to AIDS. Find out about voluntary counselling and testing for HIV in your community.

Here are a couple of other things to keep in mind:

  • If you are a pregnant woman and suspect that you or your husband is infected with HIV, get tested.
  • Testing for HIV is a private matter between you and your doctor or health care worker.
  • If you find you are HIV-positive, see if there is a support group. Support groups for men, women and couples can help overcome feelings of shame and pain of being HIV-positive and having infected children. Support groups can also help you learn about your choices to help you all live longer, healthier and happier lives.
  • Honesty and smart planning will help to prevent infecting your child with HIV.

Our program today has left us with a lot to think about. Tune in next time to learn what you can do to prevent infecting your child with HIV after you become pregnant. Thank you for listening. I’m your host []. And you’ve been listening to [].


Part Three

Characters:

Host

Mariba:
a young mother who has AIDS

Host:
Thank you for tuning in to our show today. For those of you who just joined us, we’re continuing our series on issues that affect children with a program on a topic that many people find difficult to talk about — HIV and AIDS. It’s a topic we need to talk about because HIV affects children too. Each year around the world, more than 800,000 children under 15 are infected with HIV, the virus that causes AIDS. Most of these children contract the disease from their mother during pregnancy, labour and delivery, or from breastfeeding. More than four and a half million children have already died of AIDS.

In a moment, we’ll hear a young mother’s story. But first, it’s important to keep in mind that this is not just an issue between a mother and her baby. While it is true that HIV passes to the child from the mother, the father may be responsible. Women often contract the disease from the baby’s father. In many cases, neither parent is aware that they are infected. It is very important for menandwomen to know whether they are infected with HIVbeforehaving a baby, and to take the necessary precautions to prevent infecting others.

Let’s turn now to our next guest, Mariba. Mariba has been infected with HIV for nine years and recently developed thrush, an infection that is related to AIDS. She’s here to tell us what she did to prevent her son Danbo from getting HIV. Welcome Mariba, and thank you for joining us today to share your story.

Mariba:
I’m pleased to be here.

Host:
Tell us about your pregnancy.

Mariba:
When I was three months pregnant, my husband got very sick with tuberculosis. He died before Danbo was born. At the time I didn’t know that his TB was related to AIDS. But then I got a bad cough myself, and when I went to the clinic, they tested me for HIV. That’s how I found out. The health worker told me that I might pass the virus to my baby. I was sad and scared, for myself and my unborn child.

Host:
But your son was born healthy. What did you do to prevent Danbo from becoming infected?

Mariba:
First, I decided to have my baby at the clinic. That way I could get proper medical treatment. That’s one step in reducing the risk of infecting the baby. Second, I started a special drug program for HIV/AIDS called antiretroviral therapy.

Host:
As I understand it, antriretroviral therapy is effective in controlling symptoms of the disease, and preventing transmission from mother to baby — before and after birth. But it’s expensive! How did you manage it?

Mariba:
I’m lucky, because I was in a program that gives free treatment. It’s true, it is difficult and expensive to get the drugs. But many of us are working to change this.

Host:
Okay, so tell us about the therapy.

Mariba:
I started the drugs before Danbo was born. Once I started the drugs, I began to feel better. I was given another antiretroviral drug just before Danbo was born, and Danbo had one dose just after he was born. Now he is two years old, and he is not infected with HIV.

Host:
What about the danger of passing the virus through breastfeeding?

Mariba:
I was advised not to breastfeed my baby because he might get HIV through my breastmilk. Women in my support group showed me how to prepare infant formula using clean water. But it’s still very hard. In my village, it is considered shameful not to breastfeed your baby. And most of my old friends have shunned me because I have AIDS.

Host:
That is a lot to deal with. On the positive side, you saved Danbo from contracting HIV.

Mariba:
Yes, and for that I am grateful. I am glad that I was tested before Danbo was born. And I am grateful for the support of my new friends.

Host:
That raises a very important point. Testing, and counselling, and talking about this topic — all these things help. It’s about supporting, not blaming, each other. You are part of a support group now, aren’t you?

Mariba:
Yes, I am part of a group of women who have the virus, or are sick with an AIDS-related illness. We meet to share problems and advice. People need to understand that we are not sick all the time. The illnesses come and go. If we take care of ourselves, we can work and look after our children for a long time. Living as long as I can to look after my children is what keeps me going. I also volunteer to speak publicly, to spread the word about preventing mother-to-child transmission of HIV. Men and women need to talk about their HIV status before conceiving a child, so that they can do everything they can to prevent their child from becoming infected, or decide whether or not to have a child at all.

Host:
Please take care of yourself Mariba, and thank you for sharing your story with us.

MUSIC TO END SCENE.

Acknowledgements

Contributed by Belinda Bruce, Vancouver, Canada.

Reviewed by Iain McLellan, Consultant in international behaviour change communication, Montreal, Canada.

Information sources

Positive Prevention: Prevention Strategies for People with HIV/AIDS: Draft Background Paper. International HIV/AIDS Alliance, July 2003.

More, Mona. A Behaviour Change Perspective on Integrating PMTCT and Safe Motherhood Programs: A Discussion Paper. The Change Project/AED and The Manoff Group, Washington, DC, March 2003.

Oberzaucher, Nicola, and Richard Baggaley. HIV Voluntary Counselling and Testing: a gateway to prevention and care. UNAIDS.
Email: unaids@unaids.org

Black, Poor, Female and HIV-Positive in Brazil.” Mario Osava. Inter Press Service. 6 Nov. 2002.

Love overcomes shame of HIV in Thailand and Laos.” Rohan Kay. International Federation of Red Cross and Red Crescent Societies. 8 Jan.2002.

Preventing Mother-to-Child Transmission of HIV. AVERT.org. 8 Sep. 2003.

Other Resources:

Positive Women’s Survival Kits provide education, support and resources targeting women in developing countries who have little or no access to printed materials.

The Survival Kit covers issues such as dealing with the diagnosis, relationships with family and children, grief and loss, nutrition, staying healthy, safer sex, pregnancy and breastfeeding.

Contact:
The International Community of Women Living with HIV/AIDS (ICW)
2C Leroy House
L436 Essex Road, London
N1 3QP, UK.
Tel: 44 171 704 0606
Fax: 44 171 704 8070
Email: icw@gn.apc.org