Wednesday, May 03, 2006

Drug resistance for moms

One of our talking points regarding the barriers to care for people living with HIV/AIDS has to do with women and the choices that they must make between their own care and that of their children. There's the fairly common set of choices based on economics--does she pay for her meds or pay for her children's needs, whatever they are? Then there's the set of choices based on the resources of person--does she devote her attention and focus to maintaining her own health so that she will be able to continue to care for her children, or does she shift her focus to her children and let her own health go? These choices are even more complicated when one or more of her children are also HIV-positive.

There is, however, a special set of choices to be made when a woman is pregnant. Does she take the medication needed to prevent transmission to her child or does she not? That may seem like a no brainer until you consider that it may mean changes in her own treatment, not only for the short term. A new research study discusses the persistence of resistance to nevarapine one year after a single dose intended to prevent perinatal transmission. According to the study, nearly a quarter of women retain that resistance at one year.

People may quibble over whether a woman who is HIV-positive should have a child once she knows her status, but many women do not discover that they are HIV-positive until after they are already pregnant. A time when her thoughts may have been centered on the new life in her body and her hopes for the future becomes a time when the pregnant woman must quickly assimilate not only the fact of her infection but a whole ream of medical information regarding her own treament and prognosis. How does she have a chance at understanding the importance of drug resistance right then?

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