HIV/AIDS testing is imperative for all individuals, but due to recent unfavorable trends, health officials are urging pregnant women to make sure they’re being tested to prevent disease transmission.
“A few years ago, we noticed a significant increase in the number of perinatal exposure or babies being born to HIV positive mothers and the babies being positive themselves,” said Andrea Perez, HIV prevention program manager for the Indiana State Department of Health (ISDH). “We figured part of the problem was that pregnant women were not being screened.”
Perez said the state agency also found that women assumed their doctor was aware of their HIV status because they were receiving regular checkups and having their blood drawn frequently. According to Indiana law, every pregnant woman should be tested for HIV as a routine part of her prenatal care unless she specifically declines.
To raise awareness in pregnant women and remind health care providers of the law, ISDH has revamped its One Test Two Lives campaign with a new website. There, people can access resources to medical providers, women can get their questions answered, understand Indiana law and receive contact information among various helpful resources.
Although the state wants pregnant women to be more vigilant about perinatal HIV testing, Perez said it is possible for an HIV positive woman to birth a HIV negative baby.
“Without any treatment for the mother, there’s a 25 percent chance the baby will be positive. If that mother is treated appropriately and effectively throughout her pregnancy she can deliver a healthy baby. Sometimes the doctor opts for a cesarean section to better control fluid exchange. Sometimes its just a matter of starting the baby on medication immediately after birth to reduce the chances of transmission down to 1 or 2 percent,” said Perez.
For kids who do contract HIV from their mother, life is extremely challenging.
“For babies who are born to HIV positive women, they will require at least a triple drug therapy potentially for the rest of their lives,” said Dr. Elaine Cox associate professor of clinical pediatrics and the director of infection prevention at Riley Hospital for Children.
All babies are born with low immune systems, but for HIV positive babies their disease can multiply quickly and do significant damage to their immune system.
In addition to traditional children’s doctor’s visits, kids living with HIV must see an infectious disease specialist. Kids who are asymptomatic are seen about four times a year and blood is drawn each time. They also take medication multiple times a day and oftentimes doses require pills that are hard to swallow by small children.
“You have to be on top of this. You cannot miss doses or be late. This virus is very smart and any opportunity it gets to learn about the medications, it can become resistant,” said Cox.
For kids whose disease is not as manageable they require much more mediation and can have weekly doctor’s visits. Minor health issues become major for HIV positive kids. Hospitalization is sometimes necessary to treat these added illnesses.
Cox said toddlers typically “go with the flow” of their HIV treatment, but kids don’t stay little forever. Some older kids don’t feel comfortable with their disease being known, struggle academically due to missing school because of their disease and oftentimes have trouble making friends.
“They want to go to sleepovers or camp, but they have to take all this medicine. How are you going to explain what the medicine is for? It is complicated,” said Cox.
She added that since essentially all pediatric HIV infections occur through mother to baby transmission, the child’s mother is also dealing with her own health care.
HIV medications are also exorbitantly expensive. Asymptomatic patients can spend up to $3,000 per month on medications. There are federal programs to help patients pay for care, but Cox said it requires vigilance to remain qualified for certain programs.
Due to quality of life challenges and public health reasons, all pregnant women are encouraged to take advantage of the One Test, Two Lives campaign, especially Black women. According to the ISDH, Black women account for 65 percent of all newly reported cases among women. Health experts aren’t clear as to why Black women are so disproportionately represented among HIV/AIDS cases.
The key to not acquiring HIV is prevention and for those who are at risk for contracting it must be tested regularly. While many have embraced regular HIV testing, both Cox and Perez say there is still misinformation and fear surrounding the disease. Cox said about 40 percent of adults who screen positive for HIV are not found until they are up to the point of AIDS.
Time has also diminished some of the “fear factor” that used to be associated with the disease in the ‘80s and ‘90s.
Perez said that while it’s possible to live a long life with HIV, it may not be an easy life.
“In the beginning, I remember seeing people as part of their prevention presentation lay out their medication for one day and it would take up almost the whole table. They were taking what we call drug cocktails. Today, some people can control their HIV with one pill a day, however, HIV and AIDS can be preventable – you don’t have to take any of these pills,” said Perez.
With campaigns such as One Test Two Lives, health officials are working hard to make sure the public remains informed about HIV and AIDS.
For more information, visit CDC.gov; the Indiana State Department of Health at (317) 233-1325 or visit ISDH.in.gov; or log on to StateHealth.in.gov.
