World AIDS Day 2011 | Fit Pregnancy

World AIDS Day 2011

12.01.11 The world of AIDS today

Today is World AIDS day, a global educational opportunity to raise awareness about HIV/AIDS, celebrate the people who are living with HIV and remember all those who have died.  There are World AIDS events taking place all around the world, as there has been every December 1 since 1988. As frightening and daunting as AIDS is, there’s really a lot to celebrate. 

When we first becoming aware of HIV/AIDS in the 1980s, it was a death sentence, mostly confined to the gay community.  As the epidemic and our understanding of the disease spread, we grew to understand that anyone could get it.  Anyone could have it. Anyone could spread it. Since it can hang out in your body for a decade before you ever realize it, you could be spreading it to others without knowing it. That’s why, 30 years later, HIV/AIDS is a global epidemic.  It’s simply because most people don’t know if they have it.

As of the most recent statistics (2009), there are approximately 33.3 million people in the world living with HIV.  Almost 16 million are women and 2.5 million are children.  In the US those numbers look like this:

There are 1.5 million adults and children living with HIV/AIDS.  About 70,000 adults and children were newly infected in 2009 and about 26,000 Americans died of AIDS. 

Many people think that America’s got a handle on this disease, but the reality is the number of people infected gets larger every year.  It’s estimated that in 2010, 34 million people were living with HIV/AIDS. 

Unprotected sex is still the main way that people get infected.  Women are at greater risk for contracting the disease through unprotected heterosexual contact than men, because of our anatomy, biological vulnerability and because we aren’t generally the ones in control of the condoms. Many women are unaware or careless about safe sex.  Some don’t have much say in their relationship about whether or not they have unprotected sex. Many have no idea they’ve ever been exposed (maybe from a long ago lover or brief event they don’t ever think of any more).

How do children get it?  The biggest mode of infection of children is through mother-to-child transmission during pregnancy, childbirth or breastfeeding.  But if Mom knows she has HIV and takes the right precautions and medications, the chances her child will get it from her are very, very slim. That’s if she knows and here’s where the news about HIV get much more optimistic. 

People who know their HIV status don’t have to die from AIDS anymore and that’s what we’re celebrating today.  People who take antiretroviral medications now live with the disease, but are at much less risk of transferring it or dying from it.  Antiretrovirals are a miracle, but they only work when people know they have HIV and can get and afford the drugs.  

Most American women get HIV tested as part of their prenatal care.  I’m remembering two women, who delivered almost two decades apart who had entirely different experiences with their HIV tests.

I was in nursing school in 1988, when a young woman arrived in labor. This was a big-city hospital that took care of a lot of uninsured patients and patients who had no other medical resources.  It was obvious when she arrived that she was very sick. She was thin, had a chronic cough and terrible skin. She hadn’t had prenatal care, in part because she knew she was HIV positive and in part because she was addicted to drugs.  People with HIV weren’t always treated as kindly as they should have been back then and this woman looked like she’d spent her whole life being treated badly.  She knew she would die from the disease and that her baby would probably get it from her and die from it too.

There were medications patients could use back then that bought them time (and for many people, it bought the enough time that they lived to see antiretrovirals change their disease for good), but she was scared, young, uninsured and living a crazy and dangerous lifestyle. Getting medical care just wasn’t part of her reality.  She told us her HIV status before we ever touched her because she didn’t want to infect anyone else.  She delivered her baby and left the hospital without him.  He went into medical foster care and though I never knew what happened to that young girl, I’m quite sure she’s not alive today.  Maybe her baby is, maybe not.

A few years ago, another young woman arrived in labor.  She and her husband knew they were both HIV positive long before they were married.  Both were on antiretroviral medications and were very healthy. Neither had any symptoms or signs of illness and their lab tests indicated that the disease was not active at all.  Because they knew their HIV status and were on medication, their child was at very little (almost no) risk for contracting the disease.    For them, HIV is not a death sentence.  It’s simply a chronic condition and as long as they continue to take their meds, they’ll most likely be fine. It’s a miracle. 

The key to surviving HIV/AIDS is knowledge.  Get tested. The reason why the disease is spreading, even though we’re right next door to finding a cure is that most people who have HIV still don’t know it.  They’re continuing to have unprotected sex, spreading this disease further and further.  And the people they infect won’t know it and will have unprotected sex and spread it further, and those people will have unprotected sex…But if they know…then everything’s different.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.


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