Stigmatization Slows Kenya's Efforts to Avert Mother-to-Child HIV Transmission

Pregnant women in Kenya are giving birth to HIV-infected babies either because they do not know their HIV status or they are avoiding the hospitals. Stigma and discrimination are driving their behaviors. At a recent forum in Nairobi, on mother-to-child HIV transmission, Dr. William Maina, head of Kenya's National AIDS/STD Control Program (Nascop), said that in spite of the country's great improvements in the fight against HIV, stigmatization is still a challenge. People with the disease are frowned upon, and, as a result, the fear keeps women away from the hospital.

An estimated 13,000 women give birth to HIV positive babies annually, a decrease from approximately 23,000 in 2007. The reduction is due to the government's efforts to strengthen prevention of mother-to-child transmission (PMTCT) services offered in the country. PMTCT services are available at approximately 5,000 private and public health facilities and are free at public hospitals. Also, pregnant women who go to the hospital for delivery or attend a prenatal clinic are given the HIV test. If the result is positive, they are counseled and encouraged to attend clinics. Maina noted that only about 67 percent of pregnant women who know their status fully attend prenatal clinics. Many women avoid the clinics and hospital and resort to traditional birth attendants or deliver in poorly equipped health centers. Without treatment or proper counseling, mothers may transmit the disease to the infant in the womb, during the birth process, or when breastfeeding.

Mercy Achieng, an HIV positive woman who mentors HIV-positive pregnant women, explained that stigmatization is a major hindrance to the country's goal to eliminate perinatal transmission of HIV. She noted that the discrimination is worse for pregnant women, and it begins with the family. Also, at the hospital, some nurses stigmatize patients, abuse them, and make negative comments. As a result, the women may choose not return to the hospital or clinic. In addition, violence against women and poverty contribute to mother-to-child HIV infections. Women are unable to negotiate condom use with their husbands or make them go for an HIV test, and many men who know their status do not inform their wives. Some women breastfeed their infants because they cannot afford to buy formula, and thus may pass the disease to a baby that was born healthy.

Kenya aims to eliminate perinatal HIV transmission by 2015. Toward this end, the country recently launched a program called Elimination of Mother-to-Child Transmission of HIV.