Vera (not her real name), 40, found out she had HIV, the cause of AIDS, a few months after the birth of her son. Unaware of the infection, she breastfed the child, who was later also diagnosed with the virus. The revolt and the feeling of guilt led the mother to abandon the medication.
In 2017, as she did not follow the treatment, complications from pneumonia put her in a coma for seven months. A little over three years ago, she got to know the Criança Aids Project, in São Paulo.
Since 1991, the entity has been assisting children and young people with HIV. Even outside its target audience, the NGO also ends up welcoming mothers who, infected and without a proper diagnosis, transmitted the disease to their children and accompanies them in treatment. Vera and her son, now 14, are doing well.
Contamination by HIV through breastfeeding is one of the forms of vertical transmission of the virus – when the child is infected by an STI (Sexually Transmitted Infection) during pregnancy, childbirth or breastfeeding.
Pregnant women are advised about the risk of breastfeeding for the baby and, soon after delivery, the Ministry of Health protocol indicates that the mother with HIV should receive an injection that inhibits milk production.
However, there are still cases in which, without receiving the diagnosis of the infection during prenatal care or acquiring it later, women end up breastfeeding and transmitting the virus. “Women have a very high viral load and the chance of transmission through breast milk can reach up to 40%”, explains Daniela Bertolini, an infectious disease specialist who collaborates with the Criança Aids Project.
For Adriana Galvão Ferrazini, president of Criança Aids, accompanying families living with HIV makes all the difference.
“We have cases of families in which a child of parents living with HIV was not infected during pregnancy or at the time of delivery”, he says. “Transmission also did not occur at the time of breastfeeding, because the family was instructed by the interdisciplinary team of the project.”
The housewife Lúcia (not her real name), 46, was not informed in time. She only knew she was a carrier of the virus when her son, a little over one year old, had stomatitis, which causes inflammation of the oral mucosa.
Lúcia’s son had stomatitis sequelae, with aggravating HIV infection, and was hospitalized for more than two months. The housewife says she was desperate. During the entire pregnancy, nothing had been detected. She believes she was infected postpartum.
During prenatal care, pregnant women are often tested for STIs. However, after childbirth, no further tests are performed, and unprotected sex can expose breastfeeding mothers.
Like Vera, Lúcia refused to take the medication for a long time, despite claiming to have never forgotten to give it to her son, who is now 21 years old. In 2010, the family started to be assisted by Criança Aids, where they go four times a week.
In order to avoid postpartum contamination, the Ministry of Health recommends, for pregnant women and their partners, the use of condoms in all sexual relations, in addition to PrEP (Pre-Exposure Prophylaxis), which allows the body to be prepared to face a possible contact with the virus.
According to the DCCI (Department of Chronic Conditions and Sexually Transmitted Infections) of the folder, between December 2019 and June this year, 20,553 pregnant women were diagnosed with HIV.
The number of cases of HIV infection among children up to five years of age in Brazil fell by 87% between 2009 and 2021, “which demonstrates that monitoring during pregnancy of a pregnant woman with HIV brings positive results regarding the interruption of vertical transmission” , says Bertolini.
Babies whose mothers live with HIV are entitled to milk formula distributed by the SUS (Unified Health System) until they are six months old. In São Paulo, food is provided free of charge up to two years of age.
Based in Vila Saúde, south of São Paulo, the Criança Aids Project currently serves 46 children and adolescents from 22 families. In addition to support in treatment, the NGO offers professional training and helps families with food baskets.
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