| Latin America: HIV/AIDS and pregnant women |
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| Escrito por Alba Trejo | |||||||||
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There has been little progress in specialized care for HIV-positive pregnant women in Latin America. In the last six years, over 14,700 babies have been born with the virus in Argentina, Bolivia, Colombia, Cuba, Guatemala, Mexico, Paraguay, Peru, Uruguay and the Dominican Republic. The actual number, however, seems to be much higher because there are no reliable data on mother-to-child transmission in the region. The procedures that are available to prevent neonatal infection are not of public knowledge, and only Caesarean operations are performed for this purpose. The legislation in force does not help women make informed decisions in sexual and reproductive health. Out of 3.2 million inhabitants in Bolivia, around 12,000 are HIV-positive. While this is one of the lowest prevalence rates in the area, there are no statistical data over the number of children and parents who have died of AIDS. A report indicated that five babies had been born with the virus last year. The situation in Mexico is very similar. Out of a 95-million population, some 3,000 children have contracted the virus in the last 30 years. There is no information on the number of children who have died of it, however. There are data available in Uruguay. A total of 68 children have been killed by the pandemic in the last 21 years. They all failed to receive antiretroviral (ARV) therapy on time, according to a report of the Ministry of Public Health’s Epidemiological Surveillance Division. Out of 28 million inhabitants in Peru, around 36,000 have been HIV-infected and 1,800 babies have been exposed to mother-to-child transmission risks. The current number of HIV-infected children exceeds 1,500. Ten percent die before they turn one and 90 percent, before they are five years old, said a Ministry of Health document entitled National STI, HIV and AIDS Prevention and Control Strategy. On the other hand, some 4,700 babies have been born with the virus in Guatemala, according to a report of the National AIDS Program. The number of children whose parents have died of AIDS will reach 44,000 next year. There are no data available, however, on the number of children killed by the virus. Jorge Quian, director of the Children’s Health Program at the Uruguayan Ministry of Public Health, told SEMlac that there is no local information on the number of children whose parents have died of AIDS. There is updated information in Cuba, however. There are 25 children HIV-infected, mostly due to vertical transmission, late mother diagnosis, or pregnant-women carelessness. Ten children have died of AIDS since 1986, when the first HIV case was determined. Screening tests in Colombia made it possible to detect 1,127 HIV-positive pregnant women (out of 547,164 under study) in the 2003-2007 period. Out of this total of positive women, 827 were on prophylaxis, and only 30 children got infected. A report of the UNAIDS Office in Peru indicated that merely one third of pregnant women go for diagnostic tests and around 600 babies are born with the virus every year. Guatemala faces a similar situation. A UNAIDS study revealed that 40 percent of pregnant women give birth without knowing whether or not they have been HIV-infected. Diagnostic tests are performed on all pregnant women (upon consent) in Uruguay and Cuba. There are national treatment protocols under implementation in the two countries. UNAIDS consultant Hernán Laca told SEMlac that the treatment in question involves the use of three ARVs from the 14th week of gestation to delivery. The Dominican Republic had reported 2,663 HIV-infected children by late 2008, despite free diagnostic tests. There are pre- and post-test counseling services, antiretroviral therapy for mothers and children, and food supplements for babies in the country. Out of 1,795 Caesarean operations performed at the Women’s Hospital in Uruguay last year, 305 involved HIV-positive women. Positive women in Peru and Bolivia are urged to undergo Caesarean to prevent mother-to-child infection on delivery. The so-called Mercy Inns in Mexico have diagnostic tests available to pregnant women, support them throughout the gestation process and on delivery, and provide follow-up to children for two years. The National Vertical Transmission Prevention Program in Paraguay has made it possible to keep the number of infected children low. Gloria Aguilar, coordinator of the National AIDS Program, highlighted the need to increase the number of HIV tests on pregnant women. Around 60 percent of Guatemalan women are indigenous and have deeply rooted cultural and religious beliefs. Most husbands relate HIV testing to infidelity. “Against this background, midwives play a key role in providing these women with information on vertical transmission,” said Mariel Castro, director of the National AIDS Program in Cuba. “We need to further train local midwives,” she added. There is free ARV treatment available in Bolivia, Peru, Guatemala, Cuba, Mexico and Paraguay. Norberto Fonseca, a specialist at the National Prevention Center for STIs, HIV and AIDS in Cuba, indicated that all HIV-infected women are informed about vertical transmission risk and therapy. Infected pregnant women in Paraguay are given the opportunity to undergo Caesarean and have their babies under treatment without breast feeding. In Argentina, however, only one every four infected babies has access to ARVs, ANDI news agency reported. ARV costs range from 800 dollars to 2,500 dollars per child a year. Gustavo Rojas, chairman of the Presidential Council on HIV/AIDS in the Dominican Republic, said that there are today 10,270 people on ARV therapy, including 800 children. Vertical transmission in Mexico has dropped by eight percent thanks to ARV therapy for pregnant women. “Advanced treatment makes it possible for local children who are born with the virus to live up to 20 years,” stressed a representative of the National AIDS Commission. Out of 1,286 HIV-positive pregnant women in Colombia, 77 percent are on ARV therapy. Highly effective ARV treatment is available to all those registered at public-health institutions in Peru. Around 17,000 children in Peru, 33,000 in the Dominican Republic and 128 in Cuba have seen their parents die of AIDS. Experts feel that failure to have massive diagnostic tests performed, certain cultural traditions, and poor healthcare are leading to new HIV infections in children all over the region.
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