BCH Physician Travels to Zimbabwe to Help Prevent the Spread of AIDS
Forty million people in the world are infected with HIV, the
virus that causes AIDS. Over five million cases were newly diagnosed worldwide
in 2001. Of those cases, more than 95 percent are found in resource-poor
countries, where treatment options are generally unavailable, unaffordable, and
socially taboo.
Dr. Avinash Shetty, a pediatric
infectious disease specialist at Brenner Children's Hospital, visits Harare,
Zimbabwe four times each year. He educates women on how HIV is transmitted,
hoping to prevent further spread of this global epidemic.
Zimbabwe has one of the highest HIV prevalence rates in the
world. A third of Zimbabwe's HIV-infected population is pregnant women who pass
the virus to their infants during pregnancy, at the time of labor and delivery,
and through breastfeeding. Through community mobilization, education and
research Dr. Shetty hopes to stop the spread of the disease and provide new,
cost-effective preventive regimens to prevent mother-to-child transmission of
HIV in Zimbabwe, including breast milk transmission.
"Overall, breastfeeding accounts for 33-50% of HIV
transmission in infants," Dr. Shetty said. "By increasing HIV
awareness in the community, educating couples and new mothers to the risks of
breastfeeding when HIV positive, and encouraging them to seek testing and opt
for preventive treatment, we can reduce the alarming number of new AIDS cases
in infants and children diagnosed each year."
Breastfeeding is vital for a baby's health and confers
nutritional, immunological, developmental, psychological, social and economic
benefits. In resource-poor settings, formula feeding is unaffordable,
expensive, not feasible, and even dangerous (due to unsafe water, and poor
hygiene) leading to significant risk of infant deaths due to diarrhea and
respiratory tract infections. Furthermore, breastfeeding is the social norm in
many developing countries, where new moms are expected to breastfeed their
infants for as long as 24 months.
"We know that 75% of breast milk transmission of the
AIDS virus occur during the first 4-6 months of a baby's life," Shetty
said. "Each month that an HIV-infected mother breastfeeds her infant
increases the chance that the baby will test positive for HIV." Developing
safe and effective strategies for reducing the risk of breast milk transmission
during the first 4-6 months of life and making breastfeeding "safer"
in these infants is a pressing research issue.
However significant barriers to effective HIV/AIDS
prevention and care exist. "New moms don't want to be tested to see if
they are HIV positive," Shetty said. "They fear being ostracized from
their families and often are beaten by their husbands if they test positive for
the virus."
"Another barrier to treatment is the cost of current
medications," Dr. Shetty said. "Most people in resource-poor
countries cannot afford the medications that would help them. Lack of political
will further compound the problem. Studies need to be conducted to develop new,
more efficient methods of treating the HIV infection so that more people can
receive the necessary medical care and reduce the spread of the disease."
Most HIV transmissions in this region occur through
heterosexual contact and many women are infected by their spouses and do not
know they are HIV positive until they come to the clinic for prenatal care.
Shetty and his research team see over 10,000 women each year
- a third or more are pregnant women who are HIV positive. Many effective
regimens for preventing mother-to-child transmission have been developed, but
political will to implement these strategies is urgently needed.