India has the third highest rate of HIV-infection after South Africa and Nigeria. The problem is particularly acute among pregnant women because they pass the virus on to their newborn children. The western Indian state of Maharashtra has taken some actions to stop the AIDS epidemic. Help desks have been set up for this campaign.
An HIV positive woman observes a blood test for HIV detection at a free clinic in India
Mulund is a prospering suburb in the Indian metropolis of Mumbai. Local trains heading to the city centre clatter along the eight railroad tracks intersecting the densely populated neighbourhood. The local hospital is not that far from the train station. Behind the washed out light green façade a staircase leads to the side wing of the clinic. A large red ribbon is painted on the door to the local HIV/AIDS information centre.
Poonam Nagara is one of two psychologists working there. She says the information centre is open to everyone.
“People residing nearby or people residing near the suburbs come over here. Usually people belong to low class, low status, who come over there and get themselves tested. People come here because they would have had some sexual contact or intercourse and when they come to know the fact about AIDS and HIV, they get terrified and they come over here to find out what the thing is and whether they are positive or no.”
Counselling sessions for women
Recently there has been a sudden increase in pregnant women asking for free consultation and blood tests. Not all of them come voluntarily, says Hemangi Sarode, the other psychologist of the team.
“There is a protocol that says that each and every pregnant lady has to be first directed to the counsellor; for a counselling session on HIV and AIDS. We then call her for an individual pre-test counselling session, where we, you know, we can collect her information about her husband’s behaviour, sexual practices, choice of contraception and all these things. After this you basically get an idea about what kind of chances that she is probably infected with the HIV virus.”
Breast feeding poses risk
Hemangi Sarode noticed a sharp increase of HIV infections among pregnant women. The highest risk of transmitting the HIV Virus from mother to child is during the delivery. Breast feeding poses another risk with a likelihood of infecting the newborn put at 20 percent. Bottle feeding, also called top feeding, and reduces the risk to almost zero percent. But not all mothers can afford it, she adds.
“It is a matter of money that is why most of them despite of knowing the risk, choose breast milk over top feed, it is exclusive breast feeding for the first 6 months, because that nutritional support is very good for the child’s immune system.”
Mothers do not maintain a follow up visit
But then after 6 months the mothers wean the baby off. That moment often also means the end of consultation. Hemangi says, “These ladies never maintain a follow up. Why? Because after six months we are supposed to do the first test on the child’s blood and she is so scared, she doesn’t want to acknowledge the fact that her child could be an HIV positive case. So these people do not come back to us.”
But giving up is out of question for these two women. Hemangi’s colleague, Poonam Nagara, is convinced that their work has a positive influence on the mothers: “We have to counsel them enough that it is not an end of life! The span of life depends upon their hands. And they have to really look after their diet, their health, and other contacts with people, relationships, work and everything.”
The psychologists in the information centre say they want to help the mothers lead a good life and they hope the mothers will also look at it the same way and will heed their advice to avoid unnecessary suffering for their children.