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Archive for the ‘ThisCORDANT Notes’ Category

Ibrahim Umoru

At the early years of the HIV and AIDS epidemic when treatment was a mirage, a woman testing positive to HIV gives up hope of bearing a child for the fear of having HIV+ children.

With the advent of robust treatment, care and support; our women folks taking advantage of Prevention of Mother to Child Transmission(PMTCT) services smile with relief for the ability to have babies who are HIV+. What a wonderful world!

However, as a father, a husband and somebody living positively and constructively with HIV, I sure do have a role, in fact a bold and big one at that, in my wife’s effort at accessing PMTCT. I play strong roles in supporting my wife on treatment to attain a robust CD4 count and undetectable level of HIV in her blood. It is my responsibility to make her have a good nutrition and maintain a good health as well as encouraging safer sex to the time of peak ovulation. This is to reduce re-infection.

One of the ways to prevent mother-to-child transmission of HIV involves a long course of antiretroviral drugs and

Make sure she sees a midwife:Living up to his responsibility beyond just getting her pregnant:source:africanfathers.org

avoidance of breastfeeding, which reduces the risk to below 2%. In developed countries ,the number of infant infections has plummeted since this option became available in the mid-1990s.

Since 1999, it has been known that much simpler, inexpensive courses of drugs can also cut mother-to-child transmission rates by at least a half. The most basic of these comprises just two doses of a drug called nevirapine – one given to the mother during labour and the other given to her baby soon after birth. These short-course treatments, combined with safer infant feeding, have the potential to save many tens of thousands of children from HIV infection each year.

However, for the whole robust course of a full ARV regime, opting for elective CS, alternative infant feeding; men’s roles are obviously essential and we MUST be there for our female partners.

It is important to note that as husbands we have a role to play to make the period of pregnancy less stressful for wives and always be there for them and for the union too. In encouraging my wife to consent to elective caesarian section, I continued with such support and was in the theatre by her side when she had her baby.

This is my opinion about men being part of the solution rather than the problem. We played a role in the pregnancy and since we cannot carry it (the pregnancy) we should be responsible enough to support and  encourage the woman till she enters the labour room.

If we all agree with this summation, then we can collectively agree that the term PMTCT which is Prevention of Mother To Child Transmission of HIV  should  be broadened to  read PREVENTION OF PARENT TO CHILD TRANSMISSION OF HIV (PPTCT). We all should work for that success as I and  my darling wife continues to celebrate the birth of our latest baby born HIV free baby.

Have a pleasant day!

Ibrahim Umoru

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Ibrahim Umoru

When HIV is in the family, divorce comes knocking, love flies out of the window. This seems the story of most homes affected by HIV. And Im really hoping we can stop this trend..and that is why I appreciate the opportunity offered by Nigerian Health Journal to educate subscribers to this blog on HIV sero-discordance and how we can protect ourselves and our families against HIV infection. And just in case we are already infected or affected by the virus, how to live a happily and fulfilled life.

Like the Moderator hinted earlier I will be sharing mostly my experience on this blog how I have been able to live with HIV for the past 10 years and counting as well as experiencing gained form helping families affected by HIV stay together and strong

It won’t be out of place to set this discourse rolling by providing some background information to help us understand what sero-discordance is all about.

HIV discordance refers to a pair of Sexual partners in which one is HIV positive and the other is  HIV negative. This condition has caused several painful, dreadful experiences in once beautiful marriage. When HIV infection enters the family, it heads straight to the root of the relationship and starts breeding discords, suspicion and worst still dissolution of the relationship. All thanks to the high rate of stigma and discrimination encapsulated in the robust level of ignorance in the society.

Whenever a married man or woman gets infected with HIV something else very precious to that individual also gets infected. Suffice to say that the first target of attack as soon as HIV infects a married person is his/her marriage. It is no longer news that many marriages are daily lost to HIV infection in Nigeria. The once loving husband or wife suddenly becomes a foe the moment their spouse comes home with a HIV positive test result.

Divorce seems the next destination and before you know it both partners are heading their separate ways. This would have been less worrisome if they remain lonely. But they are soon involved in fresh relationships thus increasing their chances of either getting infected, re-infected or infecting someone else. But a simple, yet fundamental support by way of education and counseling could help address these anomalies.

No doubt a wide gap exists as far as AIDS response in Nigeria is concerned. This gap includes the need to strategically reduce the number of AIDS related divorces. Marriages must be preserved. Homes need not break or disintegrate with HIV infection. There can be much love after HIV infection. This is why I would rather invest so much in building

Can your marriage withstand it when the HIV test says "positive"? source:blackchristiannews.com

HOMES than just building Houses!

Two types of HIV discordance have been identified in the course of our work.

Soft Discordance or Discordance Simplex: This is a condition where the woman is HIV positive and the man is negative. This classification is done based on the need for child bearing. In Nigeria and indeed Africa, childbirth is the icing on the relationship of any couple. In this condition the woman needs to have a relatively high CD4 cells, very low viral load or preferably undetectable and with the support of the medical team and the counselor, the woman  can collect the sperm of the male partner during her ovulation period in a sterile syringe without the needle and introduce it to her vagina. She can get pregnant with this simple method and continue with other Prevention of Mother to Child Transmission (PMTCT) practices as may be prescribed by the medical team. In our environment, the financial cost implication of this practice is very minimal hence I ascribe the terms   ‘Soft’ or ‘simplex’.

Hard Discordance or Discordance Complex: This is a condition where the male is HIV positive and the female is negative. Getting the female pregnant with minimal chance of infection can be very complex. This happens to be so as the sperm of the male which though is HIV free is in the medium of the semen that carries HIV, hence would have to be separated from the HIV carrying semen before introducing it into the woman. The financial cost implication of this procedure, sperm washing and artificial insemination is outrageously high. Most fertility facilities in Nigeria shy away from this practice and rather would refer couple in this condition to facilities in South Africa and Europe. This is most regrettable and frustrating to the couples and even the supporting counselors too.

With robust counseling support over time, it has been prove couples could live happily. Hence, our national response to HIV need to bridge the gap that exist in the peculiar need of this group by increasing the services of the tertiary HIV care centers  to include sperm washing facilities and expertise while enhancing couple communication and disclosure.

Ibrahim Umoru

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Ibrahim Umoru has been living with HIV for over a decade. He is the coordinator, Network of People Living with HIV/AIDS in Nigeria (NEPWHAN)Lagos Chapter, a peer health educator and currently engaged in some form of advocacy that seeks to address the issue of HIV among sero-discordance couples.

Ibrahim Umoru

Not a few people will admit that one of the things HIV does most times to any family is that it rips it apart by first breaking the marriage and setting couples against each other. This has especially where there have been cases of established or suspected infidelity. But Umoru feels this shouldn’t be.

“I think couples can still live happily ever after even with HIV”, he says. If a man who is HIV negative can decide to marry an HIV+-and vice versa,I don’t see why any marriage should break up because one of the couple tested positive to HIV.” Is he alone in this reasoning? Does anyone really share such audacious optimism?

Beginning from this week, Umoru will be coming your way with updates on HIV sero-discordance and how families affected by HIV can cope and still stay strong together. Most of his articles will based on his personal experience of living openly with HIV form more than 12 years .You can always visit this blog and click on ThisCORDANT Notes for regular updates.

Best regards.

Kingsley Obom-Egbulem

Moderator

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