[procaare] HCC:Post Conference discussion -17

[Insight Initiative Team <insight@hdnet.org>]

HCC: Post Conference discussion - 17
- Marge Berer, United Kingdom
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[Moderators note: Response to HCC: Post Conference discussion-12 ]

In response to the question raised by the author of post conference posting 12, which
reads "From these intervention strategies both the mother and child should be able to
expect a number of improvements in health.  But how true is this?"  I would like to offer
the following comments.

This is not the case. Interventions with antiretroviral drugs given to women in late
pregnancy and to women and infants around the time of birth are only intended to prevent
transmission of HIV from mother to infant at that time. The dosage and duration of
treatment is not aimed at treating the woman and she will experience no improvement in her
health because of it.

These drugs and regimens are used as monotherapies because each is effective on its own in
a short-term way but only for the purpose of preventing perinatal transmission of HIV from
mother to infant. To treat any adult long term, and presumably also any child with
advancing HIV-related illness, only triple therapy has the health- and life-prolonging
effect your team was asking about.

HIV positive pregnant women in developed countries who are at a stage where they need
triple therapy are using it for the long term, including during pregnancy and afterwards,
and this also prevents perinatal transmission of HIV from mother to infant. Many of us
have been arguing that triple therapy should also be made more available in developing
countries, at least to pregnant and breastfeeding women, in order to keep them healthy and
alive and therefore able to care for their children.

We are now beginning to see this happening on a very limited scale and hopefully it will
increase rapidly with generic drugs being produced and distributed more widely and drug
prices coming down. But a lot of work will be needed to make this a reality for most women
in most developing countries. Brazil is one of the few where this is offered to all adults
who test HIV positive, because it is legally required.

Marge Berer
Editor Reproductive Health Matters
London NW5 1TL, UK
E-mail: RHMjournal@compuserve.com
Internet: www.elsevier.com/locate/rhm


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The Insight Initiative Project is managed by Health & Development Networks (HDN) in
collaboration with the Thailand Red Cross Society, the World Health Organization and the
Royal Thailand Government, with financial support from AusAid and UNAIDS.

For more information about this project (the 'Insight Initiative'), visit the HDN website
at: http://www.hdnet.org

Fifth International Conference on Home and Community Care for Persons Living with HIV/AIDS
Chiang Mai, Thailand - 17-20 December 2001
Website: http://www.hiv2001.com


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