Adhiambo*, 24, conscientiously followed her health worker's advice when she was pregnant with her third child. She attended antenatal visits, was tested for HIV and found negative, and delivered her baby at the local health centre.
So she was stunned when an HIV test three months after delivery revealed she was HIV-positive.
"Being tested for HIV was normal to me because I understand it helps to know my status and also protect my unborn child; I was happy when I tested negative while pregnant," she told IRIN/PlusNews. "When I went back for my results for a pap smear, I was told I had lesions on my vaginal walls which could result in cervical cancer, and I was counselled and told to go for another HIV test. I couldn't believe I was HIV-positive. I don't know how it happened."
Women like Adhiambo - now awaiting the results of her baby's HIV test and wondering how to tell her husband - are the reason the Kenyan government is now considering a policy of repeat HIV testing during pregnancy.
The results of a 2009 Kenyan study released during the 17th Conference on Retroviruses and Opportunistic Infections, held in San Francisco in February, showed there was "relatively high HIV incidence during pregnancy and the immediate postpartum period".
A second study conducted in Swaziland recommended repeat HIV testing in labour and delivery to increase access to antiretroviral drugs for mothers who sero-convert during pregnancy.
Gaps in policy
"These results should be looked at with a view to introducing repeat testing even if only in very high prevalence areas like Nyanza... currently, the lack of it is a gap in our policies," Peter Cherutich, head of HIV prevention at the National AIDS and Sexually transmitted infections Control Programme, told IRIN/PlusNews.
"Testing should be done periodically, even after childbirth, because a mother can become infected even during the breastfeeding period. These are gaps that need to be closed."
At present, HIV-positive mothers and their babies in Kenya are given a combination of three antiretroviral drugs after a single test, usually carried in the early stages of the pregnancy.
In the Kenyan study, repeat tests were carried out among mothers who had earlier tested negative during prenatal care visits in Nairobi and Western Kenya; 2.6 percent of them had sero-converted and most of whom were from high prevalence areas - Nyanza Province has a prevalence of 15.3 percent.
"Imagine a woman who tests negative during her prenatal test, and gets infected during the pregnancy, and is not given the necessary medication during labour to protect the child; she stands a chance of infecting her child at birth or even during breastfeeding and you go back to square one," Cherutich said.
Infants contracting HIV through their mothers account for about 20 percent of an estimated 166,000 annual HIV infections in Kenya.
Safe sex during pregnancy
John Kinuthia, lead researcher in the study, said it was important to promote safe sex among pregnant women.
"The emphasis on safe sex should not end with pregnancy; there is even more need for it during this period due to their vulnerability and it is imperative for health workers to counsel mothers on their vulnerability," he said. "Efforts should be put in place to involve male partners in mother-to-child transmission prevention programme."
NASCOP's Cherutich noted that polygamy, lack of partner testing, low partner status knowledge and misconceptions about condom use among married couples were some of the key impediments to the promotion of safe sex among pregnant women.
Involving men
"The social structure as it is today still has men [leading] issues to do with sex; women have very little say on some of these things and especially in a marriage," he said.
"We have upped efforts to involve men in prevention of mother-to-child transmission programmes but it hasn't picked up properly; getting men is still a challenge," he added.
A 2009 study in the capital, Nairobi, found that male partner involvement in PMTCT was associated with reduced vertical transmission, increased HIV-free survival, and reduced mortality for HIV-negative infants. Despite this, according to the Ministry of Health, just 10 percent of women who attend antenatal clinics are accompanied by their spouses.
ko/kr/mw
* Not her real name
So she was stunned when an HIV test three months after delivery revealed she was HIV-positive.
"Being tested for HIV was normal to me because I understand it helps to know my status and also protect my unborn child; I was happy when I tested negative while pregnant," she told IRIN/PlusNews. "When I went back for my results for a pap smear, I was told I had lesions on my vaginal walls which could result in cervical cancer, and I was counselled and told to go for another HIV test. I couldn't believe I was HIV-positive. I don't know how it happened."
Women like Adhiambo - now awaiting the results of her baby's HIV test and wondering how to tell her husband - are the reason the Kenyan government is now considering a policy of repeat HIV testing during pregnancy.
The results of a 2009 Kenyan study released during the 17th Conference on Retroviruses and Opportunistic Infections, held in San Francisco in February, showed there was "relatively high HIV incidence during pregnancy and the immediate postpartum period".
A second study conducted in Swaziland recommended repeat HIV testing in labour and delivery to increase access to antiretroviral drugs for mothers who sero-convert during pregnancy.
Gaps in policy
"These results should be looked at with a view to introducing repeat testing even if only in very high prevalence areas like Nyanza... currently, the lack of it is a gap in our policies," Peter Cherutich, head of HIV prevention at the National AIDS and Sexually transmitted infections Control Programme, told IRIN/PlusNews.
"Testing should be done periodically, even after childbirth, because a mother can become infected even during the breastfeeding period. These are gaps that need to be closed."
 The emphasis on safe sex should not end with pregnancy; there is even more need for it during this period |
In the Kenyan study, repeat tests were carried out among mothers who had earlier tested negative during prenatal care visits in Nairobi and Western Kenya; 2.6 percent of them had sero-converted and most of whom were from high prevalence areas - Nyanza Province has a prevalence of 15.3 percent.
"Imagine a woman who tests negative during her prenatal test, and gets infected during the pregnancy, and is not given the necessary medication during labour to protect the child; she stands a chance of infecting her child at birth or even during breastfeeding and you go back to square one," Cherutich said.
Infants contracting HIV through their mothers account for about 20 percent of an estimated 166,000 annual HIV infections in Kenya.
Safe sex during pregnancy
John Kinuthia, lead researcher in the study, said it was important to promote safe sex among pregnant women.
"The emphasis on safe sex should not end with pregnancy; there is even more need for it during this period due to their vulnerability and it is imperative for health workers to counsel mothers on their vulnerability," he said. "Efforts should be put in place to involve male partners in mother-to-child transmission prevention programme."
NASCOP's Cherutich noted that polygamy, lack of partner testing, low partner status knowledge and misconceptions about condom use among married couples were some of the key impediments to the promotion of safe sex among pregnant women.
Involving men
"The social structure as it is today still has men [leading] issues to do with sex; women have very little say on some of these things and especially in a marriage," he said.
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A 2009 study in the capital, Nairobi, found that male partner involvement in PMTCT was associated with reduced vertical transmission, increased HIV-free survival, and reduced mortality for HIV-negative infants. Despite this, according to the Ministry of Health, just 10 percent of women who attend antenatal clinics are accompanied by their spouses.
ko/kr/mw
* Not her real name
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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