HIV & Mothers

An African proverb says that every woman who gives birth has one foot in her grave. Dark as it may sound, it is the grim reality for thousands of pregnant women in sub-Saharan Africa. Besides the rampant poverty and lack of development in sub-Saharan Africa, this region is the world’s epicenter of the HIV epidemic. How do pregnant women fare in these conditions?

Pregnant women with HIV have higher mortality rates than women with HIV because, HIV severely weakens the body. Compared to HIV-negative women, HIV-positive women are six to eight times more likely to die from pregnancy and birth-related causes. In sub-Saharan Africa, 24% of maternal deaths are caused by HIV (WHO). Most maternal mortality from HIV occurs directly from the viral disease itself, although other indirect causes such as sepsis and anemia contribute to mortality because the disease compromises the mother’s immune system. Lack of awareness about the importance of early HIV detection and treatment also contributes to high rates of HIV among girls and women.

Women are disproportionately at risk for HIV due to sexual and social inequality. Many women are not given the power to make decisions about safe sex, which often leads to HIV transmission and unplanned pregnancies. Social stigmas associated with being HIV-positive also drive many women to hide their status when at clinics, thus losing access to antiretroviral treatment. When talking with Amnesty International, a woman said, “[I]f I go for antiretroviral, my line is that side. All the people in this line, they know these people are HIV. That’s why people are afraid to come to the clinic.” Other women forgo medical treatment altogether, afraid of the potential humiliation that may result if their HIV status is revealed.

When we stop to reflect on the situation of thousands of women in sub-Saharan Africa who do not survive pregnancy, maternal mortality becomes a very sobering issue. In the context of the HIV/AIDS epidemic, giving birth in sub-Saharan Africa is vastly different from giving birth in the United States, but it does not mean that women in sub-Saharan Africa don’t deserve the same quality of care. The epidemic has far-reaching consequences for pregnant women and their unborn babies, as it causes a plethora of additional health issues. The special needs of HIV-infected pregnant and postpartum women must be addressed in the fight against maternal mortality.

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