HIV positive mothers in Kherson oblast in Ukraine know their children can be born virus-free
A UNICEF supported project reduces mother to child HIV transmission to less than 5%.
The rapid spread of HIV/AIDS in Ukraine in the past five years has given the country one of the highest epidemic rates in Europe. Expert estimates indicate that every hundredth Ukrainian is now HIV positive, and the number of children born to HIV positive mothers has increased dramatically, with about 300 such cases each year in the Odessa, Donetsk and Dnipropetrovsk oblasts – the worst-affected regions. More and more frequently, HIV infection is being diagnosed among pregnant women who do not belong to any particular high-risk groups and who live in ‘normal’ family conditions.
At the office of the charity foundation ‘Mangoost’ in Kherson oblast, a well-known HIV service institution, we met Nina Gordeyeva, a young mother and social worker who is also the regional representative of the Ukrainian Network of People Living with HIV/AIDS.
“Three years ago, when I registered at the maternity hospital I found out that I was HIV positive”, Nina tells us. “Of course I was absolutely horrified. I had just read a book where the main heroine was a hospital nurse who finds out that she is infected with HIV. By nature I am cheerful and optimistic but on discovering my HIV status I could not stop crying. I told my husband about it immediately, but although we had lived together happily for several years, he refused to believe me and would not take an HIV test. Even now he is completely ignorant of his HIV status though I have really tried to persuade him to go for a test. I worry about his health but he can not overcome his fear, especially the fear that if the result was positive people would find out at work.”
She continues, “I am a very open person; perhaps it was this frankness that made me reveal my HIV status and start working at ‘Mangoost’. I found support there and, more importantly for me, I was able to help others, especially young women.
“These days I deal with a number of HIV positive pregnant women, describing my own experience and explaining that life is not over just because you know that you are HIV positive. I feel good about myself and approach life with joy and happiness. Unfortunately my husband and I got divorced when our daughter Dasha was born, but I am really happy – I have a healthy and cheerful daughter. Now she is two and a half, a clever little girl who knows lots of rhymes, likes singing and will soon start going to nursery school. Most important of all – she is completely healthy.”
In October 2003, 71 children were born to HIV positive mothers. Because of the kind of laboratory diagnostic methods available in Ukraine, their HIV status could not be diagnosed until they were 18 months old. Most were found to be virus-free, largely because of the antiretroviral medication given to pregnant women and their newborn children. Specialists say that such timely treatment with antiretroviral medicine gives an HIV positive mother a good chance of giving birth to a virus-free baby. According to statistics, the number of HIV positive women who have the courage to give birth to their children is increasing and many hope to have more than one child.
Now the Kherson Region HIV/AIDS Prevention Centre, the Social Services for Youth Centre and UNICEF have joined forces on the Vertical Transmission Prevention Project.
Nina often visits the maternity wards in Kherson where HIV positive mothers give birth, to show them a real example of someone living with HIV and to give them hope that their children will be born virus-free. Nina feels inspired when she sees despair fade and hope rise in the eyes of mothers-to-be and their families.
One mother, Olga, discovered that she was HIV positive when she became pregnant. She never took drugs but she had unprotected sex with her boyfriend and blames herself for her situation. Having broken up with her boyfriend, and married her new love, Olga had to decide what to do about her pregnancy. The advice and support she received from the experts and volunteers at the Prevention Centre helped her recover from the shock of finding out that she was HIV positive. Nina helped her to overcome fears and convinced Olga that she should go ahead and have her baby.
“At the maternity unit they gave me antiretroviral therapy and the doctors and all the medical staff treated me with understanding and respect,” remembers Olga. “My daughter was born beautiful and healthy, with a good appetite. I am not feeling tired at the moment, so I can do a lot of work around the house. I feel that my husband supports and helps me; he loves to play with our daughter after work. I am so thankful that he is HIV negative. We are planning to have a son once our daughter is a little bit older…”
HIV/AIDS specialists in Kherson report that most HIV positive pregnant women come from families that could be regarded as ‘normal’. They are often students or teachers and do not use drugs. They usually have one sexual partner and are not involved in sex work. In many cases, women have been infected by husbands who have tried drugs in the past. There are also many couples where the husband is HIV negative, and both partners dream of having children. They are very disciplined and follow every medical advice, taking a keen interest in the conditions needed to ensure their baby can be born virus-free.
Even the strongest families need help. Very often, successful and secure families affected by HIV/AIDS try to deal the problem on their own, without telling anyone. All those affected need social care and support, but some need particular help. The Vertical Transmission Prevention Project is currently providing support, for example, to four single-parent families.
“What really matters is that these single young mothers have agreed to receive aid from us”, says Dmytro Mutsenko, Director of the Social Services for Youth Centre. “We advise them on legal and social matters. Our Centre is about to sign agreements on social support with several more young HIV positive families that need special care and support from us in finding employment or accommodation. We also train social workers in the treatment of HIV positive pregnant women and families bringing up HIV positive children.”
In cooperation with AIDS Centre and Centre of Social services for Youth that works with UNICEF support, the ‘Mangoost’ Charity Fund works with HIV positive women. At each of its eight needle exchange points in Kherson, social workers and volunteers provide psychological advice, distribute information materials explaining the HIV/AIDS epidemic and issue free syringes and condoms.
‘Mangoost’ staff have, quite literally, saved children’s lives, as in the case of drug user Tetyana. Tetyana, a commercial sex worker, continued to work at the roadside until the moment she went into labour and an ambulance took her straight to the maternity ward. After the birth of her daughter Tetyana went straight back to work, leaving her baby by the road. As Tetyana firmly believed that she would abandon her child, it was difficult to persuade her otherwise. Her baby was given to the Kherson Baby Home and the staff at the Home lavished great care upon baby Olenka. The girl still looks very sickly but at least she is now receiving loving care and attention. The baby home also looks after a number of babies who were abandoned by their HIV positive mothers. It is still unclear whether these babies will be HIV positive when they reach the age of eighteen months, but since they received the medicine Viramun within a few hours of birth, it is highly likely that these children are virus-free.
Today there are 18 HIV positive pregnant women registered at the Kherson Oblast HIV/AIDS Centre. All have had advice from medical specialists before and after their HIV test and have expressed their wish to have their baby. In October 2003, three gave birth, having been treated with Retrovir in their 36th week of pregnancy and their newborn babies having received Viramun. According to Dr.Yaroslav Ziatiuk, Chief Physician at the Centre, specialists and paediatricians keep an eye on the babies and advise their mothers on breastfeeding or bottle feeding. Dr.Ziatiuk confirms that complex measures including antiretroviral medication, timely HIV testing, exclusion of breastfeeding and, if necessary, a Caesarean section all help to lower the risk of mother to child transmission to 5% or even less in Kherson.
Vertical or mother to child transmission at the prenatal stage, during delivery or through breastfeeding is one way in which HIV is spread. It can and must be prevented. The prevention of mother to child HIV transmission is a measure that not only saves lives, but revives hope for a healthy society.
The Vertical Transmission Prevention Project has been implemented since May 2003 in Kherson oblast with the support and assistance of UNICEF. The project covers all HIV positive pregnant women in the region.