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Living A Positive & Productive Life

Times of India
01 December 2010
By Ashish Tripathi
Lucknow, India

PPTCT Prog Helps Prevent Prenatal Transmission Of HIV From Infected Pregnant Mother To Her New Born
WORLD AIDS DAY DECEMBER 1 WORLD AIDS DAY DECEMBER 1
Raghav gifted a toy bicycle to son Kunal who turned four last week. "He (son) was asking for it for past six months," said Radhav, a private executive, while explaining how the pampered child has changed his life and that of his wife Sushma. The couple was tested HIV+ in 2000 at the time of the birth of their first child who was HIV+ as well and died within a month.

They resigned to their fate with no charm for life. But in 2006 they came to know about the Prevention of Parent to Child Transmission (PPTCT) programme and decided to go for a baby. "It was the happiest day in my life when Kunal was born and that too with no virus. Now we have ‘a purpose’ to live," said Sushma.

Though the PPTCT programme was started in the country in 2002, it picked up pace in the city and the state in last couple of years. Many HIV+ couples like Raghav and Sushma are opting for PPTCT today despite the fact that the success rate of the programme is around 50%.

Living A Positive & Productive Life
"But it’s worth trying," said Deepak, a programme officer in a non–government–organisation. Deepak was tested positive in 2005. He came out of depression and got a job with the help of Amitabh Awasthi, president, the Lucknow Network of People living with HIV and AIDS (LNP+).

In 2007, Deepak married Lata who was also HIV+. "With Lata in my life, I got support, love and care. The desire to live revived. Last year we went for PPTCT," he said while hugging his one–year–old daughter Prerna.

In UP, the programme was first started in Chhatrapati Shahuji Maharaj Medical University (CSMMU) followed by all government medical colleges and today it is available in all district women hospitals.

The programme requires an integrated effort of a haematologist specialising in HIV, a gynaecologist and a paediatrician among others. Some private hospitals also offer the service. Besides providing HIV+ couple the joy of being parents, the programme also helps in spread of HIV.

The PPTCT aims to prevent the pre–natal transmission of HIV from an HIV infected pregnant mother to her newborn baby. The PPTCT or Prevention of Mother–to–Child Transmission (PPMCT) of HIV provides drugs, counselling and psychological support to help safeguard infants against the virus.

"Today people living with HIV/AIDS can live a ‘productive’ life. In PPTCT, we administer antiretroviral medication to pregnant women during last trimester of the pregnancy, generally at the time of labour to prevent HIV infection passing from mother to baby.

The chance of transmission of the HIV reduces from 30% to 50% with administration of nevirapine in mother at the time of labour pain and a dose to the new born.

Researches have shown that the chance of transmission is further reduced if two antiretroviral drugs are given during the last three months of the pregnancy," said Prof AK Tripathi, head, Haemato–oncology unit and nodal officer AIDS care, CSMMU. "In last two years, over 50 HIV+ couples who came PPTCT to CSMMU were blessed with HIV– babies.

"Loneliness is a bigger challenge than the virus," said Devdutt, living with virus since 2002. After undergoing counselling at LNP+ and CSMMU, he married a HIV+ woman in 2004 and decided to go for PPTCT in 2007. He was blessed with a daughter.

However, the joy was short lived as the wife died within a year. "Now my daughter is the only motivation for me to live," said Devdutt, who dreams of making his daughter a doctor. Prof Tripathi said "A happy family life helps HIV+ manage life in a better way because the dose of love and care enhances the impact of medicines."

Amitabh, who himself is HIV+ for last nine years, along with his HIV+ wife Tripti has helped many overcome depression and shed fear of stigma, says "HIV is deadly but not big enough to kill human will."

(Names of HIV+ve couples have been changed)
Global, Regional & India Estimates
  • 33.4 million people worldwide were living with HIV in 2008
  • 2.1 million children under 15 were living with HIV in 2007
  • 2.1 million people died of AIDS–related causes in 2007
  • 2,90,000 children under 15 died of AIDSrelated causes in 2007
Prevention of Parent–to–child Transmission
  • In India, the transmission of the virus from the mother–to–child during pregnancy, labour and delivery or breastfeeding is called parent–to–childtransmission
  • One of the best practices in PPTCT in India is the outreach approach by the ICTC to ensure that HIVpositive women are followed up before, during and after an institutional delivery and provided with antiretroviral prophylaxis
Paediatric Care and Treatment
  • It is estimated that 70,000 children below the age of 15 are living with HIV in India
  • 21,000 children are infected every year through parent–to–child transmission
  • A small proportion are also infected by unsafe injections and infected by blood transfusions
  • Most children are infected with the virus while still in the womb, during birth or while breastfeeding
  • The National Paediatric Antiretroviral Treatment (ART) Initiative was launched in 2006
  • Medicines to treat infections such as TB, Pneumonia etc, antibiotic to prevent infections followed by antiretroviral therapy (ART) – drugs combination to restrict virus multiplication. ART discontinuation or non–compliance is harmful.
Facilities at CSMMU
  • Free tests to confirm HIV status.
  • Counselling for rehabilitation.
  • Paediatrics ART for children.
  • Obstetrics and gynaecology services
  • ART centre.Free treatment
Diagnostic Services at Other Hospitals
  • SGPGI, Jhalkari Bai Women Hospital, Shyama Prasad Mukherjee Hospital.
  • Lucknow Network for People with HIV and AIDS Helpline: 9335743180.
  • For women 9459112275. email: lnpupnp@yahoo.com and amitabhlnp@yahoo.co.in

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