WOMEN, PREGNANCY AND HIV/AIDS

Information for a healthy and happy life

You may already know that... AIDS is caused by a virus called HIV or Human Immunodeficiency Virus. HIV attacks the body's immune system, weakening it so it is unable to fight off diseases including those common ones like flu and cough. A person who is infected with HIV is termed HIV-positive (or, person with HIV). This does not necessarily mean that the person has AIDS.

AIDS is the name given to the group of illnesses, which occur in HIV-positive people as a result of a weakened immune system. The most common of these illnesses are pneumonia, tuberculosis, certain types of cancers, yeast infection and a number of skin disorders. These opportunistic illnesses may occur many years after a person is infected with HIV.

Women who aspire a healthy and happy life should know that HIV could be transmitted in three ways:

1. Through unprotected penetrative sex with an infected person, where body fluid from the infected person enters the partner's body. Body fluids include semen, pre-ejaculatory fluid, vaginal fluid and blood (including menstruation).
2. Through infected blood, such as through contaminated needles or syringes, blood transfusion or organ transplant.
3. From an infected mother to her baby during pregnancy, giving birth and breastfeeding.

Overall, about 30% of babies born to HIV-positive women are infected with the virus. However, the possibilities can be reduced with anti-HIV therapy such as using AZT.

Young girls are highly susceptible to HIV infection. If they live in low social status, it makes them even more vulnerable.

Know your own health status besides being aware of your partner's.

When choosing a partner, be sure that you make a wise decision that will protect yourself. Find out the answer to these questions:

• Is he free from HIV or other sexually transmitted diseases?
• Is he faithful, or does he have another partner (now or previously)?
• Is he, or was he a drug user?
• Is he a sexually active man? What kind of sexual activities has he been involved in?

Meanwhile, ask yourself these questions:

• Are you free from HIV, hepatitis or other serious diseases?
• Are you sure you are perfectly healthy?
• Have you been using drugs?
• Would you need any kind of blood test?

Requesting for safer sex from your partner is your right and responsibility.

One reason many women lack confidence in asking for safer sex is that they feel their partner's sexual pleasure is more important than their own well-being.

Remember that you are putting your life at stake by practicing unsafe sex. Asking for safer sex does not mean you are making a moral judgment about his behavior or yours. It also does not mean you are doubting his faithfulness. Safer sex is a health protection - a way of protecting both of you.

A woman is three to eight times more likely than a man to get infected with HIV via unsafe sexual intercourse.

What if he refuses to practice safer sex?

If reasoning and coaxing fail, maybe you should consider leaving a partner who cares more for his own pleasure than your life.

If you are married with children, appeal to your husband's sense of responsibility as a father. Imagine what would happen to the children if both of you are infected with HIV.

Get Help

Understandably, if you are economically dependent upon your partner, or are afraid of being left for someone else, safer sex can be a difficult subject to bring up. Some women are also afraid of physical violence or abuse from their partners. When you need confidential counseling and referrals, call the Malaysian AIDS Council at (03) 445 1033.

The invisible threat

The early stage of HIV infection normally does not show any sign or symptom. A person may look healthy and feel fine even if she has been infected. This condition can last for many months, even years. This is very dangerous because the infected person can infect others while not knowing that he or she is infected.

The only way to ascertain if one is infected with HIV is by taking the HIV Antibody Test. If you can get your partner to take the test together with you, so much the better. Don't forget to seek counseling before and after taking the test. Take the test before you plan to get pregnant.

If the doctor confirms that you are HIV-negative*, then you can continue with your pregnancy. Nevertheless, ensure that you do not become infected before and after pregnancy.

On the other hand, if you are diagnosed as HIV-positive, the doctor will provide you with further advice to prepare you for the safest delivery, for you and baby.

*The Test is to be taken at least three months after possible exposure, to allow the body to produce enough antibodies. If your first Test shows a negative result, you will be asked to take another test after three months.

Which women are at risk?

All women. As the receptive (passive) partners during sex, all women are exposed to greater risk of infection as compared to men.

Whether you are young, old, rich, poor, heterosexual, bisexual, gay or currently celibate, all women should be aware of the risks and ways to avoid infection.

Whether you are HIV-positive or negative, if you are pregnant, always ensure that your health is adequately maintained.

Prevention

You are not ready to get pregnant and you don't want to be infected. But you need loads of love and sex! Is there a solution?

Safer sex can prevent pregnancies and reduce risks of exposure to infections.

In medical terms, safer sex refers to sexual activities that do not involve transfer of body fluids to the partner. This includes having sex with proper use of condom.

Remember, sex does not always mean intercourse. Touching, kissing, hugging, massaging and masturbating (where there is no broken skin), are examples of safer sexual activities.

Presenting the condom: The 2-in-1 Protection!

• Prevents unwanted pregnancies
• Prevents infection

To prevent infection and pregnancy, you need a constant supply of condoms and the power to use it or to request your partner to use it.

Contraception methods other than the condom, such as the Pill, IUD, diaphragm, spermicide etc do not prevent HIV infection.

How to put on a male condom:

1. Check the condom packet to make sure that the condom had not passed its expiry date. Then, carefully tear open the packet and take out the condom.
2. Put the condom on the head of the erect penis. Pinch the tip to expel air bubbles.
3. While continuing to pinch the tip, use your other hand to unroll the condom right to the base of the penis.
4. If necessary, apply water-based lubricant such as KY Jelly.
5. After ejaculation, withdraw penis carefully before it loses its erection. Hold the rim tightly against the penis to prevent spillage.
6. Take off the condom, knot the open end and dispose the condom into the garbage. (Do not flush used condom into the toilet bowl.)

Many women desire to get pregnant

To get pregnant, a woman needs to receive semen from a man. Therefore, if you get pregnant, you risk yourself getting infected with HIV or other sexually transmitted diseases if your partner has been exposed to infection from other relationships or through sharing of needles.

Your own health and your baby's are important issues that you should consider before planning to get pregnant. Talk to your partner and seek counseling. You can contact the Malaysian AIDS Council at (03) 445 1033 or any women's clinic.

If you are HIV-positive, proper medical care can reduce the risks of passing the virus to your baby.

Risks to baby

An HIV-positive woman may pass the virus to her baby during pregnancy, while giving birth and during breastfeeding. The possibility of mother-to-baby HIV infection is about 30%, but can be further reduced by:

• Practicing safer sex as soon as you are confirmed pregnant.
• Minimizing unsafe sex during fertile periods and totally avoiding it outside fertile periods and after giving birth.
• Seeking a more reliable midwife as well as a safe and comfortable maternity house. Also, avoid prolonged labor.
• Having early check-up and starting anti-HIV regime, such as using AZT, as early as the second trimester (4th month). (This must be monitored by a doctor).
• Avoid breastfeeding or stopping it as soon as possible.

On the other hand, maybe you don't want to get pregnant

• because you already have enough number of children.
• because your youngest child is still small and you want to plan your family.
• because of age factor.
• or maybe because you are not ready financially.
• Another important reason why some women use contraception (such as condom) is to avoid passing dangerous virus, such as HIV, to the baby.

If you find that you are HIV-positive when you are already pregnant, you have the following options:

1. Continue with your pregnancy:

You may continue with your pregnancy if you and your partner want to have a child. However, make sure that you get proper medical care. Practice only safer sex when you are pregnant to avoid risks of infection to your baby. Also, ask your doctor about starting anti HIV-treatment (such as taking AZT).

2. Abortion

Some women choose abortion to avoid the risk of having an infected baby. Abortion involves many delicate issues, and you need to talk to a doctor and seek counseling before making such a decision.

Whatever you choose, do not make a hasty decision. Think of what's best for yourself, your partner and baby.

Care for HIV-positive mother and baby

1. During pregnancy

Seek a doctor and get counseling immediately. You will also need proper medical care, especially until you give birth. have only safer sex if you must. If you are a drug user, you should stop taking drugs. This is the best time for you to kick the habit. Taking drugs when you are pregnant can endanger your health and the baby's.

2. Giving birth

There is no need for an HIV-positive mother and baby to be isolated, but proper care is necessary. Beforehand, it is better that your midwife is informed about your HIV status as this may help ensure a safe delivery for you and the baby, as well as for the midwife, nurses and doctors who will be treating you.

3. After birth

Newborn babies still carry the mother's antibodies, so it will be difficult to know if the baby is infected with HIV. HIV antibody tests can be done periodically on the baby, but it is normally after 18 months only that the result is accurate. If the baby is confirmed HIV-positive, you should seek a doctor's advice, followed by thorough medical care for the baby. The baby should also be immunized against all infections.

Avoid breastfeeding your baby to minimize risk of infection.

You don't have to do it alone.

When it comes to decisions regarding your health and well being, it helps to talk to others and share your problems with them. Doctors, social workers and women organizations can help you arrive at the best solutions. They may not help you solve your problems, but you will find ways to cope. Don't hesitate to contact them when in need of help.

Ultimately, all decisions lie in your hands.

Malaysian AIDS Council (Treatment Information Project)

(03) 4043 9711 or 4045 1033 ext. 202

Mon - Fri 9.00 am - 5.30 am

Malaysian AIDS Council Interactive Infoline

(03) 707 7007 24 hours

Hospital Kuala Lumpur

(03) 2692 1044 ext 5228/5238

Mon - Fri 9.00 am - 4.00 pm

Hospital Universiti

(03) 7956 4422

Mon - Fri 9.00 am - 4.00 pm

Telenita AWAM

(03) 7957 0224

Mon - Sat 9.00 am - 5.30 pm

Tenaganita

(03) 2691 3681/91

Tue - Sat 10.00 am -6.00 pm

Women's Aid Organization

(03) 7956 3488

Mon - Sat 9.00 am - 5.00 pm

Women's Crisis Center, Penang

(04) 228 0342

Mon - Sat 9.00 am - 6.00 pm

Community AIDS Service, Penang

(04) 229 9566

Mon - Fri 10.00 am - 5.00 pm

Know your rights. Assert your rights.

Malaysian AIDS Council