An Indonesian woman living with HIV, a mother and wife
Women with HIV like me have the same rights as any other Indonesian woman, including the rights to have a healthy spouse and children. (Shutterstock/File)
When I was first diagnosed as HIV positive, I never thought that I would have lived this long. I was infected through my late husband, who passed away seven years ago.
I have never used drugs or had free sex, but my husband was a user, injecting heroin under his skin. In 2009, we were both diagnosed with HIV and my husband passed away not long after that due to late treatment.
At first I was pessimistic, thinking it would be impossible for me to marry again. I was not even sure that I would survive and continue living. Things changed when I met a support group.
My motivation and will to live slowly recovered. I joined a national network of women with HIV, Indonesian Positive Women Network (IPPI). From the group, I learned about sexual health education, reproduction, gender, human rights and how women with HIV like me have the same rights as any other Indonesian woman, including the rights to have a healthy spouse and children.
In 2012 I met a man from outside the HIV/AIDS community. Two years later, we got married and decided to move from Jakarta to Bandung. Since the beginning of our relationship, we have constantly strived to deepen our understanding of HIV and pregnancy preparation. All in order to prevent HIV transmission to my HIV-negative partner and our future kid.
Our dream has come true; I am pregnant in 2016.
How can women with HIV have a healthy pregnancy? Here are some things that I am doing to make sure I have a healthy, HIV-free kid.
Antiretroviral (ARV) therapy
I’ve been in antiretroviral therapy (ART) for seven years. ART consists of drugs that function to suppress the growth of HIV in the blood, preventing the virus from attacking the immune system. This drug must be taken at an exact time every day. Aside from for health recovery, ARV is key for people with HIV who are planning on becoming pregnant.
ARV is available at certain hospitals and community health centers (Puskesmas) designated by the government for the HIV/AIDS program and for free due to a government subsidy. You must consult your doctor before starting to take ART.
(Read also: More HIV centers set up as cases rise)
Condoms and its role
Condoms are highly important for me and my husband’s sexual life. My husband is HIV free, and we are committed to keeping it that way. To prevent transmission from sexual contact, condoms must be used every time. Only during fertile days are we allowed by doctors to have unprotected sex in order to get pregnant.
Routine lab checks
During pregnancy planning, a complete blood check must be done every three months. I also have to do a routine immunity count (CD4) check every six months. Lastly, there is also an HIV RNA or viral load HIV check to count the amount of virus in my blood. If your blood check is good, the doctor will give you permission to start pregnancy planning.
No less important is the annual HIV check for my husband. In our second year of marriage, he is still healthy and HIV-free. After a series of blood checks, I was declared fit and ready to have children.
Calculation of fertile days
To minimize transmission risk, we only have unprotected sex during fertile days. Even though my immunity is good and the virus in my blood is undetected, there is still a possibility of transmission. I really had to learn how to calculate fertile days in order to get pregnant, and it worked! Last month there were finally two stripes on my pregnancy test.
Pregnancy check: To which doctor?
After getting pregnant, we have to decide the next step. We must consult a doctor, either a HIV doctor or gynecologist. In every hospital appointed by the government, there is a special work unit specializing in HIV. Among all doctors, there must be one gynecologists highly educated in HIV issues.
Delivery method and breastfeeding
Mothers with HIV can choose the delivery method and food choice for their newborns. This means that we too can have a normal birth and breastfeed. Of course, with certain precautions. There are medical conditions that we have to consider for mothers with HIV who are planning to have a normal birth, including their CD4 count and viral load, and the condition of the baby. The same goes with breastfeeding. If the mother is not medically fit, the doctor will advise a caesarian birth and infant milk formula.
(Read also: Huge challenges remain to end AIDS by 2030)
Mother-to-child transmission prevention
A newborn must be given prophylaxis, an ARV drug to prevent HIV transmission for babies. Prophylaxis usage depends on the choice of food we plan to give to the baby.
Since I plan to breastfeed, my baby will be given prophylaxis during breastfeeding. Mothers with HIV are advised not to breastfeed for more than three to six months. Once the baby starts teething, there are risks of transmission from nipple wounds. If the mother opts for infant formula, the doctor will only give prophylaxis for six weeks.
HIV check for your baby
This is one step that I am waiting for. The check will be done in three stages. First, when the baby is four weeks old using HIV RNA PCR (viral load tests), second at month six using the same method, and third at month 18 using serological testing. After following every piece of medical advice, I am very optimistic my baby will be healthy and HIV-free.
Now my pregnancy has entered its sixth week, and I feel the same way other pregnant women do: nauseated and craving. I am optimistic that living with HIV will not prevent me from having the same happiness as everyone else.
Ayu Oktariani is a 30-year-old living with HIV, dedicating her life to support others infected with the virus. A mother to one daughter who loves to spend her time reading, traveling with her family, drawing mandalas, and blogging. Her daily stories can be found at www.sukamakancokelat.com.
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