|© UNICEF video|
|Odaliz, 19, is getting tested for HIV before delivering her first child.|
By Thomas Nybo
ANTIGUA, Guatemala, 5 February 2009 – Odaliz Canrey is 19 and pregnant with her first child. Thanks to UNICEF, she’s getting tested for HIV. Although Guatemala has low HIV prevalence – less than 1 per cent of the adult population – Odaliz wants to be sure of her status.
Odaliz decides to bring her mother along for support. The two of them leave the house they share and begin the journey to the closest national hospital, where her HIV test will be given as part of her regularly scheduled prenatal examination.
About 59,000 people are living with HIV in Guatemala. Odaliz says people in her culture are afraid to discuss the virus – even basic facts like how it is spread. She says there are misconceptions about HIV among people in her village of Alotenango.
"I've seen situations where if a woman is HIV-positive, people will not touch her, they won't let their kids hang out with her or her children," says Odaliz. "There's a lot of stigma."
PMTCT in Guatemala
UNICEF's efforts on HIV and AIDS in Guatemala are focusing on the prevention of mother-to-child transmission (PMTCT). UNICEF is currently supporting 15 of the country's 37 national hospitals by offering technical assistance, human resources and HIV testing for pregnant women.
Treatment for paediatric cases is another focus. Just two years ago, Guatemala had no paediatric treatment protocols. Health workers were taking a risky approach: To treat children, they would simply cut adult pills in half, ignoring the fact that children require different doses or different medication.
Since then, UNICEF has helped the government procure paediatric treatment resources – for example, through an alliance with the Clinton Foundation, which is providing free, lifetime treatment with antiretroviral (ARV) drugs for 150 Guatemalan children.
With help from UNICEF, about 840 children in Guatemala received antiretroviral treatment in 2006 (compared to 356 in 2005). One remaining challenge, however, is getting children diagnosed early. Too often, they arrive at health centres too sick to be saved.
As Odaliz waits for her results, she sits in a crowded hospital hallway, talking with her mother. Around her, dozens of pregnant women and new mothers wait for their own results. Birth control is rarely discussed in this society, where it's not uncommon for a woman to have as many as 10 children.
Nurse Vilma Salazar says most of the women arrive at the hospital knowing almost nothing about HIV.
"They might know a little from the radio or watching television, but when I ask them what they know, they usually remain silent – which has a lot to do with the culture, with fear and shame," says Ms. Salazar.
Fear of stigma
Ana (not her real name), 24, learned she was living with HIV late in her pregnancy. A blood test revealed her status, and later tests confirmed that her husband and baby were also living with the virus. They are now receiving free ARV treatment, but she's afraid of revealing her status to friends and neighbors in Guatemala.
"Nobody in my village knows," Ana says. "I'm not going to tell them because they would be afraid they could get infected from my family."
After an hour's wait, Odaliz is called into the nurse's office. She sits down and is given the results: she is negative. She talks with the nurse about prevention strategies. They also schedule her next prenatal exam.
Odaliz walks back to the hallway and delivers the good news to her mother. She also shares a message she received from the nurse: Prevention is the key to ensure that future generations are born free of HIV.
UNICEF Representative in Guatamala Adriano Gonzalez-Regueral speaks about prevention measures for mothers with HIV.
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