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In Cameroon, a family living with HIV faces difficult choices

UNICEF Image: UNICEF image: Nevirapine antiretroviral
© UNICEF/2006/Lenka
A supply of Nevirapine, an antiretroviral drug that helps prevent mother-to-child transmission of HIV, at a health centre in Njinikom, Comoros.

By Gisele Langue-Menye

NJINIKOM, Cameroon, 10 July 2006 – Virginia, 26 and John, 31, both of whom are living with HIV, are Cameroonian peasant farmers with two children, Mary and Francis (not their real names). Encountered at the youth friendly center at St. Martin de Porres’ Hospital here, they disclosed that the purpose of their visit was a medical check-up for Francis, who also has the AIDS virus.

“I was tested positive in 2002 during my first pregnancy when I came here in Njinikom to attend the antenatal clinic,” said Virginia. “When I got my results, I became very worried. How could I tell this to my husband? How will he react to that? How will I tell my other family members?”

As Virginia guessed, her husband was shocked. “My wife came and told me her status,” recalled John. “I became totally confused and decided to come to the hospital and get myself tested. The results showed me to be HIV-positive as well. Together, we accepted the situation that way.”

Benefits of ARV therapy

During that first pregnancy, Virginia underwent treatment with an antiretroviral (ARV) medication before delivery. “The drug inhibits HIV/AIDS transmission from mother to child,” she explained. “And the baby was not at all breastfed. There was artificial milk in the hospital that was used to feed the baby. Thus it saved Mary, who was tested HIV-negative. Then we felt very confident on the drugs and decided to have another baby.”

Before delivering her second child, however, Virginia was ill and unable to take the ARVs. And because artificial milk was not then available at the hospital, Virginia opted for exclusive breastfeeding for the first four months of the baby’s life.

Replacement feeding is too expensive for the average family in Cameroon. A three-day supply of breastmilk substitutes (i.e., infant formula) costs $4, more than those earning minimum wage can afford. Furthermore, replacement feeding may be neither acceptable, feasible, sustainable nor safe for most Cameroonian mothers and families.

Many parents like Virginia and John are therefore faced with a feeding dilemma. The policy adopted by the World Health Organization and UNICEF is to provide parents with appropriate infant feeding counseling and support – thereby helping them make an informed choice of options in each context.

Virginia explains that when her second baby, Francis, was tested, “he was HIV-positive. It was very difficult at the beginning, but we finally accepted it.

Early testing and treatment

Despite the challenges she has faced, Virginia never shared her HIV status with her relatives. She gave them no details about the sickness she suffered during her second pregnancy or why she didn’t breastfeed her first baby – all because she fears the stigma and the discrimination that would result.

“It will not be accepted even by my sisters,” she said.

John, on the other hand, feels more comfortable sharing his status with friends to sensitize them to HIV/AIDS and help them avoid infection.

“What is important is to know now how to handle ourselves,” he noted. “I’m taking the treatment and the drugs are already working well. I feel free. Two things are in need now. First is artificial milk to save babies and the second is early testing of babies to get them faster into the treatment.”

Currently, UNICEF Cameroon is supporting 10 health districts where adequate services are delivered to women attending antenatal clinics. Among the services offered are counseling and testing as well as the provision of ARVs and nutrition advice.



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