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Posts Tagged ‘HIV transmission’

As we conclude our discussion on the role infertility is playing in swelling cases of violence against women and the attendant health implication especially the spread of sexually transmitted infection, perhaps it won’t be out of place to ponder on the words of Dr. Oliver Ezechi.

In a recent interview with NIGERIAN HEALTH JOURNAL, Ezechi who is consultant Obstetrician & Gynaecologist and Chief Research Fellow and in the Sexual and Reproductive Health Research Unit of the Nigerian Institute of Medical Research, Lagos said:

“The pressure from society forces men infertile relationships to engage in extramarital affairs to prove their manhood. Now, because of the intense pressure, some women will also go out searching for pregnancy especially if they suspect the fault is from the man. This is so that the woman can be at peace, save her head and shut the mouth of everyone because sometimes the torments from family members can push people to unimaginable length.”

This is puzzling, to say the least. To think that there is a married woman somewhere, currently having affairs with other men(with the approval of her husband; by the way) so she can get pregnant and protect him from society’s ridicule is  one of the weirdest thing to imagine let alone do.

It doesn’t make sense to any observer who is not too conversant with the African society and how it is dealing with

African women:when will your jubilee come?

issues of infertility. But these stories are real and like some public health physicians and epidemiologists may have realized, have added to the list of harmful cultural practices believed to be driving the HIV/AIDS epidemic in most African societies.

Part of what this reality suggests is that  perhaps, marriage is becoming particular risky and dangerous for an average African woman as it appears that she is even more exposed to HIV in marriage than as a single woman.

Doesn’t this provide the basis for interrogating some of the cases of HIV sero-discordance we’ve had to deal with in Africa?

Dr. Ebun Adejuyigbe, consultant pediatrician and associate professor, Obafemi Awolowo University, (OAU) Ile Ife, Osun State would rather say an emphatic yes to that poser and she has a strong case to support her stand.

Just  in case you are wondering “HIV discordance refers to a pair of Sexual partners in which one is HIV positive and the other is HIV negative.”

After studying several cases of pediatric HIV infection she and her colleagues have had to deal with over a period of time  and the fact that only the mothers of the children were the ones with HIV, Adejuyigbe soon discovered that sterility or sexual impotency and infertility were all at the root of the whole problem.

“We discovered that these women  with HIV positive babies apparently were encouraged by their husbands to go out and be impregnated by another man. The choice of man the woman decides to opt for would be determined by the possession of certain physical features that could clear any possible doubts about the child’s paternity. No one would ever imagine that a man irrespective of his medical condition would allow his wife to go out and get pregnant by another man and pose as the father when the child is born”, said Adejuyigbe.

That is the norm in some parts of Nigeria and the women in a bid to shield their husbands from social stigma that comes with sterility or impotence would actually go and have sex with another man and come back pregnant for her husband. But these days, the women are not only coming back pregnant. They are also coming back infected with HIV. And their husbands may  never get infected especially for those whose husbands are sexually impotent.

“I never knew this was happening until we started noticing an unusual trend at the pediatric ward in OAU. We were seeing several sick children, infected with HIV and expectedly ,you will have to talk to the parents of such kids and after encouraging the mothers to go for HIV counseling and testing; the result is usually positive”.

That is often the beginning of several revelations according to Adejuyigbe, especially if the clinician insists that the father of the child should also be tested for HIV.

“The women involved would wonder at our display of naivety if we conclude that the man probably would also be infected with HIV. But they will tell us emphatically that their husbands cannot be HIV positive. Of course, you want to ask is he not infected and the women would tell you their husbands can never get infected because “he doesn’t, and can’t have sex with them. If you probe further they will tell you because he is impotent”.

This development was confirmed following further survey and interview of several women visiting the pediatric ward with children infected with HIV. The women are counseled to go for HIV test and if the result turns out positive, they are usually not in doubt as to the source of the infection.

It all started as a problem of infertility and the need to shield themselves from the social stigma that  infertility attracts. One partner decides to cover the shame of infertility they both will have to live with and it turns out that she is actually laying down her life.

Again, the question many would want to ask is ‘how can men protect their wives from society’s ridicule if indeed she is medically confirmed to be the one with the problem that has caused the couples infertility?’

Marrying a second wife or even divorcing the woman has been the norm for most men. If a woman could decide to get pregnant by another man just to protect her husband from the shame of sterility(and eventually get infected with HIV)then men should start thinking of a better sacrifice to make when the table is against their partners.

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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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