Babies and AIDS

Babies and AIDS There are 62 million people living in Tamil Nadu today. Every year nearly 1.2 million babies are born in the state. Infant mortality rates in Tamil Nadu are among the lowest in the country, thanks to the relatively well-established health infrastructure and service in the state. Most recently, Tamil Nadu was pointed out as a model for reproductive health and child care services in the country.

Tamil Nadu is also the state where the first case of HIV was identified in 1986. Today, it leads the rest of the country in the number of cases identified. This may point more to the efficiency of the testing and services provided, than to anything else. Nonetheless, the incidence of parent-to-child transmission of HIV is significantly high, and is the biggest new cause for concern in the state.

Recent studies among pregnant women attending antenatal clinics in the government hospitals throughout the state show that between 0.33% and 4.5% of the women are infected with HIV. Significantly, more than 95% of the women tested are married and have had sex with only one partner - their husbands.

With an average infection rate of around 1% among pregnant women, it is estimated that a minimum of nearly 3,600 children with HIV will be born in the state every year. The numbers will increase if infection rates go up. Current infant feeding practices may add significantly to this number.

In 2003, the National AIDS Control Organisation (NACO), along with UNICEF, implemented several pilot projects in the country, to reduce transmission rates from parents to children, specifically from mother to child during pregnancy and after childbirth. Three of these projects are operational in Chennai.

Studies show that the use of low cost anti-retroviral therapy for women in the last trimester of pregnancy and to the newly born infant has significantly reduced the rates of transmission. Nevertheless, this has thrown up complex issues regarding support to the infected women and their families, adequate availability of alternatives to breast milk, desertion of the woman by her husband and in-laws, ongoing care for the woman and her child, etc.

The phenomenon of parent-to-child transmission cuts across all castes and classes of society and is of concern to all people who plan to have children. What should and shouldn't they be doing? What are the options available to them? What are likely consequences? What questions should they ask and whom should they seek support from?