HIV and Maternity in Pernambuco

May 11, 2009

The housewifre P.J.S, thirty-five years old, born in Recife, northeastern state of Pernambuco, could not imagine that the happiness attached to having a baby could become a judicial nightmare.

When fnding out she was pregnant of her second child, in 2003, she took all medical pre-natal care. She did all blood tests, including the HIV reagent. The doctor at Maternity Barros Lima, northern area of the city, assured her she had nothing to worry about.

The child had a normal birth delivery. Two months later, to a complete surprise, the tests came back with the news that both her and the baby were HIV positive.

Ms Kariana Guerios, attorney of Gestos, who is following the case, says this is one of four similar cases in the Juridical Counseling department of the institution. She points to the fact that prevention of mother to child transmission is still failing in the health system and that this is somewhat frequent. “For the lack of appropriate assistance, my client was told to breast feed, what is completely inappropriate for HIV positive mothers for raising the risk of the baby getting infected. But fortunately such cases are becoming more rare,” explains Ms Guerios.

The attorney filed a case of moral damage and negligence against the County in the Civil Court, asking for a pension for the child because the mother has no financial condition for the treatment and care. “They are poor. It is necessary to try and repair a damage the municipal competence because this child, that could have been born healthy, was infected with HIV because of a sloppy pre-natal.”

Data from the report of monitoring the goals of the United Nations General Assembly Special Session on AIDS – UNGASS-AIDS – in sexual and reproductive health, prepared by the UNGASS-AIDS Forum Brasil, in 2008, shows that, despite the government’s efforts, reducing “vertical transmission” or PMTCT has a wide regional fluctuation in both care and eduction.

Based on the Plan for Preventing Mother to Child Transmission of HIV and Sifilis of the Ministry of Health, 2007, there is a 0,41% prevalence of HIV infections in mothers. There is an estimate of 12,456 newborns are exposed to HIV yearly. The transmission rate of HIV from mother to child, when the treatment intervention with prophylaxis is not done, reaches about 25% of newborns of HIV+ mothers, but it can lower to one or two percent with the application of the necessary measures during pre-natal care, delivery and post-delivery procedures. Such interventions are: the use of anti-retroviral medicines starting at the fourteenth week of gestation; use of injected AZT during labor; perform cesarian section when advisable; give oral AZT to the newborn exposed to HIV from birth to forty-two days and do not breast feed, use mild substitute instead.

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Sexual and Reproductive Health and the ICPD+15

May 11, 2009

Between 30 March and 03 April, the United Nations held in New York the 42nd Session of the Commission of Population and Development (ICPD+15.) After a week of debates, the government heads present confirmed the Cairo Action Plan and broadened the reach of the International Conference for Population and Development, held in Cairo in 1994, fifteen years ago, hence ICPD+15.

The resolution the Commission reached in 2009 advanced in the sense of proposing more inter-sectorial approach for AIDS and sexual and reproductive health policies, recognizing the rights of the youth and adolescent populations and, even without citing reproductive rights, strengthening the issue as something to be present in the policies for population and development.

Other important aspects were the specific reference to the assurance of the human rights and the confrontation of stigma and discrimination of people living with HIV/AIDS; the confirmation of the commitments made at UNGASS-AIDS and the affirmation that sexual and reproductive health must be contemplated in the strategic national policies for preventing the spread of HIV and for caring for the people living with HIV (see paragraphs 16, 17, 18, and 19.) In the three months prior to the session, Gestos was active in many discussion groups about Cairo+15 and participated in the elaboration of the Latin American civil society shadow report, organized by the National Feminist Health Network, that, among other themes, focused on sexual and reproductive health of women, violence against women, and the feminization of the HIV/AIDS epidemic. According to Ms Alessandra Nilo, Gestos’ representative in the ICPD+15 Brazilian delegation, “civil society’s presence was fundamental for advancing the commitment.”