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HIV-positive And Pregnant
Being HIV-positive doesn't affect fertility, and the many advances in HIV treatments make it safe to avoid transmisison if you have a child..
At the onset of the HIV and AIDS pandemic in the 1980s in Jamaica, being HIV-positive was considered a death sentence, and the truth is that a number of people died in the early years of the pandemic. Fear, anxiety, uncertainties, homophobia, stigma, and discrimination led the way as people at all levels of society went more into panic mode, rather than showed genuine care and support for the infected and affected.
Indeed, with still much uncertainty about the treatment required and phobia relating to the idea that this was a homosexual or gay disease, in a context in which fear of homosexuality is like a pandemic by itself, those who were infected were condemned twice. That is, they were infected with a virus that would most certainly lead to their death with complications from AIDS, bearing in mind that even in death some religious leaders and groups would not conduct their funerals, and the stigma relating to spiritual, social, ideological, economic, and political engagements.
The consensus is that these were the dark ages of the pandemic, and yet there were numerous signs of hope as people risked their lives to intervene in order to care for the infected and affected.
Stigma and discrimination
Fast-forward to 2023 and one would think that, with advances in science, research, development, and almost 100 per cent increase in knowledge, attitude, and behaviour, the level of stigma and discrimination towards people living with HIV, their families and loved ones would change. Not so.
Recently, I was informed that JN+ has data, through their stigma index, indicating that women in Jamaica who are HIV-positive are being sterilised or deprived of the possibility of getting pregnant due to the very wrong and harmful perception that they are not to give birth to children due to the risk of passing HIV to the unborn child.
I am grateful, not just to scientific and medical advances, but to an Anglican priest, Canon Gideon Byamugisha from Uganda, who, in 1992, became the first religious leader in Africa to publicly announce that he was HIV-positive. Years later, at the time we spoke, on the occasion of a visit to Jamaica and the United Theological College of the West Indies, where he addressed an audience of students, faculty and various stakeholders in the fight against HIV, Canon Gideon indicated he and his wife Pamela (who is also HIV-positive) have two daughters whose names are Love and Gift, who are HIV-negative. The issue of why there would be a need to sterilise women of child-bearing age without their consent raises not just concern about stigma and discrimination, but also worry about the state of human rights and social justice in our beloved country.
Stigma is placing a label on someone without their consent, as in the practice of branding the enslaved with the names of their masters during the period of enslavement in Jamaica and other places in the Caribbean. Discrimination is putting people in categories or status based on perceived natural or social designations which it is determined best suits their name, age, gender, sexual orientation, or place of residence.
Right the wrong
Put together, and especially detrimental in the case of women and girls who are often stigmatised and discriminated against purely on the basis of gender, this serves to undermine their sense of identity as authentic human beings. Men and boys are not to be left out, as in a context in which, according to the late Professor Barry Chevannes, boys receive their socialisation on the streets — rather than at home — and with the general view that "man must have nuff gal and gal inna bungle", according to a popular reggae artiste, it is no wonder some men feel pressured to father children for whom they take little or no responsibility.
At the same time, though this orientation and socialisation of males go back to the plantation, and with the tide now shifting to more men taking responsibility for their children, there are signs that tremendous steps are being taken to right the wrongs of the past.
In this context, and bearing in mind that the rate of HIV in Jamaica still stands at approximately two people out of every 100,000 infected, this is an indication that the rate of mother-to-child transmission has decreased significantly.
The question, then, is: Why are there reports of discrimination against women of child-bearing age that are HIV-positive?
Women are as important as any other Jamaican, and everything is to be done to ensure their human rights are protected, preserved, and promoted. Furthermore, those who were reportedly sterilised without their consent must be encouraged to seek redress through the appropriate legal channels.
Advocacy for justice
In the meantime, all people of goodwill must let their voices be heard for and on behalf of those who are marginalised in society. Indeed, as Martin Luther King Jr reminds us, injustice anywhere is injustice everywhere, and with the Charter of Rights now well enshrined in the Jamaican Constitution, accompanied by the requisite protection of the rights of women, girls, men, and boys, every step must be taken to protect all citizens. Our future will only be guaranteed if women who are HIV-positive are guaranteed that a HIV-positive status is no reason not to get pregnant and give birth to more handsome and beautiful boys and girls. Social justice for HIV-positive pregnant women matters.
More Deaths Than Malaria And HIV/AIDS: What Africa Is Doing To Fight The Silent Epidemic Of Antibiotic Resistance
Each year antimicrobial resistance—the ability of microbes to survive agents designed to kill them— claims more lives than malaria and HIV/Aids combined. Africa bears the brunt of this development, which thrives on inequality and poverty. Nadine Dreyer asked Tom Nyirenda, a research scientist with over 27 years' experience in infectious diseases, what health organizations on the continent are doing to fight this threat to medical progress.
What is antimicrobial resistance?Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines (including antibiotics). This makes infections harder to treat and increases the risk of disease spread, severe illness and death.
In Africa, drug resistance is already a documented problem for HIV, malaria, tuberculosis (TB), typhoid, cholera, meningitis, gonorrhea and dysentery.
How big a problem is antimicrobial resistance?It is one of the top 10 global public health threats, and threatens to undermine years of medical progress.
Nearly 5 million deaths were associated with antimicrobial resistance in 2019.
The African continent bears the heaviest burden.
The first comprehensive assessment of the global burden of antimicrobial resistance has estimated that in 2019 over 27 deaths per 100,000 were directly attributable to it in Africa. Over 114 deaths per 100,000 were associated with it.
In high-income countries, antimicrobial resistance led directly to 13 deaths per 100,000. It was associated with 56 deaths per 100,000 people.
The study showed that young children were particularly at risk. Half of the deaths in sub-Saharan Africa in 2019 were among children under the age of 5.
How do inequality and poverty come into it?In many African countries, poverty and inequality propel the likelihood of antimicrobial resistance.
Access to clean running water, proper sanitation and safe water management is a big challenge in many hospitals and clinics in African countries.
And there is often a dire shortage of health workers. Wards are often overcrowded. As a result, infections spread faster. Some of these infections are resistant to antibiotics.
Inappropriate use of antibiotics, inadequate health resources and limited access to the right medicines has also fueled antibiotic resistance in sub-Saharan Africa.
Substandard and falsified medicines, due to their inferior doses, can allow bacteria to adapt, persist, develop and spread. Studies show that the African continent is affected by such medical products.
Global antibiotic shortages also encourage the use of inferior medicines.
With weak regulation, over-the-counter prescription of antibiotics is highly prevalent in sub-Saharan Africa. The highest rates of over-the-counter antibiotics have been found in Eritrea (up to 89.2%), Ethiopia (up to 87.9%), Nigeria (up to 86.5%) and Tanzania (up to 92.3%). In Zambia up to 100% of pharmacies dispensed antibiotics without a prescription.
Is there any good news?While tackling antimicrobial resistance on the African continent may be tougher than in other regions, many deaths are preventable.
There have been some encouraging moves to protect health systems and communities against antimicrobial resistance.
Six South African sites were involved in the clinical trial.
They advocate for the responsible use of antibiotics as well as ways to prevent and control bacterial infections.
In Kenya and other African countries, antimicrobial resistance champions raise awareness in schools, universities, clinics, and communities.
The antimicrobial resistance challenges in African countries are huge. But momentum to counter it is building.
Crucial steps include:
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why I Celebrate Life With HIV
Callum Lea was 19 years old when he learned he had HIV.
He'd recently moved from Cheshire, England, to Cardiff, Wales, to attend university.
"I'd been in Cardiff for just under a year, and I felt like I'd almost failed that first hurdle," Callum told Healthline. "I was beginning my adult life and starting to put myself out in the world, and then was I hit with this. At the time, I didn't really know anything about HIV. The word 'HIV' just sounded like a death sentence to me."
Now, nearly 10 years later, Callum is thriving. He's working as a medical secretary for the National Health Service while studying to become a counselor.
"In the past few years, I've re-evaluated my life and started to ask: What more can I do?" he said. "Because for a long time, my goal was to just get through to the end of the week. To look any further than that was overwhelming.
"But now, I have goals. I have things I want to achieve. And there's no reason why I can't do these things."
Like many people with HIV, Callum takes antiretroviral medication that has reduced the virus to undetectable levels in his body. He takes a pill once a day and attends regular checkups to ensure that the virus remains undetectable.
When HIV is undetectable, it's untransmittable. It can't be passed from one person to another through sexual contact. Reducing HIV to undetectable levels also protects against life threatening complications, which allows people who receive treatment for HIV to lead long and healthy lives.
Even with these advancements in treatment, researchers have found that receiving an HIV diagnosis is often traumatizing. Many people with HIV contend with stigma, which can negatively affect their sense of self and well-being. HIV-related stigma can also make it difficult for people to disclose their HIV status to friends, family members, and other community members.
For queer men like Callum, that stigma may be compounded by homophobia.
"I've had a lot of negative attention since I was very young. I've been jumped before, I've been attacked, I've had customers be really rude and disrespectful to me," Callum told Healthline. "So for me, it was like, once bitten, twice shy. I had this awareness that if I was public about the HIV, there could be a lot more negative attention to come.
"I think people still have that misconception that it's a 'gay disease,'" he continued. "And you know, if it happens to a straight person, 'I feel sorry for them,' but if it happens to a gay person, 'Well, they should have known better.'"
Callum chose not to disclose his HIV status to most of his friends and family members for years after his diagnosis. He told Healthline that he didn't know anyone who was living with HIV while "fully accepting themselves and thriving in life," which made it difficult to envision a positive future for himself or talk about it with others.
He dropped out of university, feeling overwhelmed and isolated. He got a job in retail as a makeup artist and lived paycheck to paycheck, earning money for rent while seeking some sense of normalcy.
He was reluctant to get into a relationship. And when he eventually did, he found it hard to advocate for himself.
"I got into that relationship and lost myself even further, I think because of how I felt about myself," he said. "I felt like I had a lot of baggage. I didn't feel worthy, and so I would accept the bare minimum. I didn't respect myself enough to hold my boundaries and really stand up for my worth. I really hit rock bottom."
When that relationship ended, the COVID-19 pandemic was in full swing. Callum moved out on his own and found himself leading a quiet life, with little to distract himself from the grief and fear he'd been living with.
"It was the first time that I'd been in complete silence, and that was the scariest," he recalled. "I think I'd always been so busy and occupied myself so I didn't really have to think about a lot of stuff," he recalled.
"I had such fear of people knowing and what they might think — of what really owning my HIV status could do to my life. But actually, I wasn't really living a life at all."
Callum realized that he needed to make a change. His doctors had been urging him to reach out for support from the Terrence Higgins Trust (THT), a charity that provides HIV and sexual health services across the United Kingdom. He finally felt ready to accept the help that was offered.
"I started getting therapy through THT, and it was the best thing that I ever did. It truly changed my life," Callum said. "Counseling gave me a safe space to tackle my own self-stigma and find acceptance in my [HIV] status, with support from someone who specialized in the common struggles faced by people living with HIV."
Speaking honestly about his experiences and fears was an important step in taking control of his life, he said. He also took part in group therapy and other support services that allowed him to hear from other people with HIV.
It was the first time in years that he felt "normal."
It also helped him recognize the great potential that life with HIV could hold.
"Talking with other HIV-positive people, hearing their stories, and understanding the significance of undetectable = untransmittable helped me to see light at the end of the tunnel, which was extremely encouraging on my journey to self-acceptance," he told Healthline.
"I was able to hear other people's stories. Like, their dating stories and that some people were married and some people had kids. That was something that I'd completely written off for myself, and so to come into a space where people had something positive to say about it? It was overwhelming."
Share on PinterestEdit by Wenzdai Figueroa; photo: Marching in Pride Cymru 2018 with fellow members of the Cardiff Lions Rugby Football Club.As Callum's self-acceptance grew, he felt more ready to share his story with other people and disclose his HIV status to friends and family members. He acknowledged that not everyone can safely disclose their HIV status, but for him, doing so was a source of relief.
"Fortunately for me, disclosing my status made my bonds with my friends and family that much stronger," he said. "A huge weight was lifted when I came out publicly. I was finally able to show people the real me, flaws and all. I was finally able to let people close to me again.
"It also opened up a conversation around HIV. I was able to educate people in my wider circle and community about HIV. It let people know that if they were struggling themselves or knew someone who was, that they had someone they could turn to for support."
Coming to terms with his HIV status opened up a whole new world of possibilities, Callum said. It gave him a sense of freedom to take more risks in life and worry less about failing.
He left his job in retail to find work in the healthcare sector. He returned to school, inspired by his own experiences with therapy to become a counselor. He also bought his own apartment, which has granted him a sense of greater independence and security.
"When you've lived in fear for so long, the small things don't seem to bother you anymore like they used to. The risks don't seem as much of a risk anymore. You've got one life to live, and I spent far too long not living mine," he said.
"Now my priorities are different. My priority is me. I don't want to survive anymore, I want to thrive. I want to live. The future is bright, and I work every day to make sure of that.
"I've also made time to open up my heart again," he continued. "With full transparency about my status, a lot of patience on their side, and lots of open communication, it's allowed me to feel equal and safe in a relationship."
Share on PinterestEdit by Wenzdai Figueroa; Left photo: At Mighty Hoopla 2023, a pop music festival in London, UK. Right photo: At Brighton Pride in 2018.Callum recognizes that people with HIV have different life experiences, and he hopes that sharing his own story will help others on their journey toward self-acceptance.
He encourages people with HIV to accept the guidance and support that's available. He encourages loved ones of people with HIV to offer support while having patience for the challenges that some might face in accepting it.
"Offer your support, but allow the person to use their own autonomy to accept the help. So much control of your life is taken away when you are diagnosed [with HIV], and it's important to let someone have control over who they tell and how they move forward," he said.
"I always had a support network and amazing nurses and doctors, but I had to come to terms with how and when I could accept the support offered. To accept help and think you need help can make people feel very vulnerable, but allowing yourself to be vulnerable is one of the strongest things you can do for yourself."
Callum Lea
Callum Lea is a 28-year-old makeup artist, medical secretary, and counselor-in-training who lives in Cardiff, Wales, UK. He has been living with HIV for 9 years. As a patient advocate, he has shared his story through multiple media outlets, as well as the Terrence Higgins Trust's "My HIV Doesn't Define Me" video and resource series. He hopes that by sharing his experiences with HIV, he can help other folks living with HIV feel less alone while coming to terms with their diagnoses.
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