Positive mother speaks out

When Yinka Jegede-Ekpe tested positive for HIV 10 years ago, at the age of 19, the last thing on her mind was marriage and children. At the time, information on living with the virus was limited and a positive status was considered a death sentence.

But Jegede-Ekpe, executive director of the nongovernmental organisation, Community of Women Living with HIV in Nigeria, and the first woman in Nigeria to publicly declare her HIV status, is now married and late last year became the mother of a healthy baby girl.

"It is like a dream come true," Jegede-Ekpe told IRIN/Plusnews. She is one of a growing number of AIDS activists in Nigeria who are becoming mothers and proving wrong the widely held belief that HIV-positive women cannot give birth to HIV-negative children.

Without interventions, 25 percent to 30 percent of children born to HIV positive mothers become infected, but Jegede-Ekpe noted that with increased levels of awareness and improved access to interventions that prevent mother-to-child transmission (PMTCT), the number of children born with the HI virus in Nigeria had decreased.

Her organisation is among a number of groups that are educating pregnant women about the need to know their status and 160 clinics and hospitals are now offering PMTCT services, but access is still mainly limited to women living in the cities.

While basic PMTCT services are provided free by the government, Jegede-Ekpe observed there are many associated costs that not all women can afford. "The free comprehensive PMTCT services being provided are not comprehensive enough. There is the cost of caesarean operations, tests and even baby food, which is not covered ... the government has to do something about this if we want to bring down the rate of mother-to-child transmission in the country."

In an interview with a local women’s magazine, “Genevieve,” Jegede-Ekpe revealed that she and her husband, who is also HIV positive, had been trying to have a baby for the past five years. A trained nurse, she knew the steps they needed to take to conceive as safely as possible and reduce the risks of transmitting the virus to their baby.

"Before conception one needs to create an enabling environment," she said. "The person's viral load has to be low and the CD4 count, which is a test used to measure the immunity, has to be very high for the mother to be healthy enough to carry the pregnancy through and for the baby to develop and be born healthy."

With guidance from a team of doctors, Jegede-Ekpe and her husband took a number of viral load and CD4 tests before it was decided there was a minimal risk of them reinfecting one another through unprotected sex.

The pregnancy was not without hitches, despite all the extra care she received at various stages. Midway through the pregnancy she suffered a painful bout of shingles; more worryingly, she discovered that her CD4 count had dropped significantly.

"I needed to do a [drug] resistance test because it seemed that one of my antiretroviral drugs was no longer effective," she recalled. "It was then they found out that I was resistant to all the drugs I'd been taking and that there was a need to change most of my treatment. They had to lower the viral load because it had started building. I took the treatment for one week then had surgery to have the baby delivered."

The baby was immediately tested for HIV and found to be negative, but then Jegede-Ekpe struggled with whether or not to breast-feed her baby. Exclusive breast-feeding is usually recommended for HIV positive women who lack access to clean water, electricity or a reliable supply of formula milk, but in her case formula feeding was judged the safer option.

Compared to many other positive mothers in Nigeria, she told IRIN/PlusNews, she felt very privileged to have been able to pay for the expensive tests and specialised treatment she received.

Despite the challenges an average positive woman faces when having a HIV-negative baby, she urged them to try, saying, "The good thing is that we now have many examples of positive women who have delivered their babies with little or no complication."

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