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A few years ago, I helped a mother deliver her third baby at a government clinic in Dar es Salaam, Tanzania. Her admission card noted that she was HIV positive – something she had discovered during her first pregnancy eight years ago. Her husband was unaware of her status and, even though clinic staff encouraged her to bring him to her checkups, she had never had the courage to do so. She had been frightened by stories of other HIV-positive women being chased from their homes due to the fears and misinformation that surround HIV infection. So here she was, trying her best to prevent transmission of HIV to her child, while keeping her status secret from her husband, relatives and friends.
The burden of her secret weighed heavily on her. She recalled how hard it was to take her daily anti-retroviral drugs (ARVs) to stay well. She understood the importance of good adherence, yet confessed to occasionally missing her dose – not because she forgot, but because her husband was present and she could not take them publicly.
The evidence shows that with the right ARV treatments, we can reduce the risk of transmission from mothers to children to below five percent. And yet, Tanzania’s current HIV transmission rate is 25.7 percent. This is not because of poor services or...