Women and HIV/AIDS

Leena* has been married to Ben* for three years, and they have been having unprotected sex because Ben insists on not wearing a condom. Although Leena feels uncomfortable about this initially, she did not want to hurt his feelings by persisting in asking him to. Leena takes oral contraceptives to prevent herself from being pregnant again after their first child since they were not ready to have any more children.

Recently, Leena felt an acute pain when she is urinating, and noticed that she has been having heavier than usual discharge. Worried, she decided to consult her doctor, and discovered that she has contracted Gonorrhea, which is a form of Sexually Transmitted Disease, or STD. This made her feel extremely hurt and betrayed. She has not been having sexual relations with anyone other than Ben since they have been married. After confronting him, she found out that he has been having affairs with several other people since her pregnancy.

After speaking to her friend about this, she became anxious about contracting HIV, and the chances of her passing it to her child if she was indeed HIV positive. What are the steps she can take to find out about this?

Human Immunodeficiency Virus, or better known as HIV, is a virus that attacks and weakens the body's immune system. When a person is infected with HIV, or is HIV positive, then his or her body's ability to fight off common diseases like flu or cold would be considerably weaken. HIV is different from AIDS, because AIDS (short for Acquired Immune Deficiency Syndrome) is a group of illnesses that can occur to a person because of his or her weakened immune system. These illnesses can include pneumonia, tuberculosis, thrush and some types of cancer.

AIDS can occur to someone many years after s/he is infected with HIV, and HIV can live in a person's body for many years without him or her realising it. There may not be any visible signs and symptoms until up to ten years or more. Therefore, to ensure that you receive treatment as early as possible if you are HIV positive, to protect your partner from HIV infection, and/or to find out if it is safe for you to get pregnant, it is advisable for you to go for an HIV Antibody Test if you have been exposed to any of the high-risk behaviours which can expose you to HIV.

What are the high-risk behaviours?
This includes unprotected sex, shared needles for injecting drugs or had blood or organ transfusion.

How about the risks to a baby?
HIV could also be transmitted from a mother to her baby during pregnancy, giving birth and breastfeeding. The possibility of mother-to-baby HIV infection is about 30% but this can be reduced further by:

• Practicing safer sex through condom use as soon as you are confirmed pregnant.
• Avoid breastfeeding or stopping it as soon as possible.
• Having an early check-up and starting an anti-HIV regime, such as using AZT as early as the second trimester (4th month of your pregnancy). This treatment is available at government hospitals for pregnant mothers who are HIV-positive for free. Otherwise, it costs RM550 for one hundred 100mg tablets.

What are the procedures for taking the test?

• Inform the doctor why you think you need to take the Test, and the doctor may then let you know if s/he thinks you should do so or not. If you decide to take the Test, then the doctor will inform you on the procedures and further steps to be taken after finding out about the results.
• The doctor will take a blood sample from you and this sample will be analysed. The process is painless and it works the same way as any other blood tests. Usually, the results can be obtained after three to five days.
• If the result is negative, you should take another test in three months. This is because there is a window period where the HIV antibodies cannot be detected even if the person is infected with the virus. After the second test, wait for another three months before taking another test to confirm the HIV negative results. If you are HIV-negative, maintain your healthy lifestyle by avoiding high-risk behaviours and practice safer sex by using a condom if you are sexually active.
• If the result is positive, a confirmation test will be done immediately. As mentioned above, a HIV-positive person does not mean that s/he will fall sick immediately. If you are HIV positive, get support through counselling and strict medical treatment to maintain your health.
• Whether your result is negative or positive, the doctor will give advice and counselling after each result. Talk to the doctor on the best ways to maintain health.

You can take the HIV Antibody Test at Government clinics or hospitals, specialist clinics, STD clinics or private clinics or hospitals. Understanding you might be anxious about taking the Test, ask if the place offers you counselling before and after the Test result and choose one that does. The HIV Antibody Test costs around RM30-35 at private labs but its free of charge when done in government hospitals.

A woman is three to eight times more likely than a man to be infected with HIV through unsafe sexual intercourse. Although you may lack the confidence to ask your partner for safer sex through condom usage, or may be afraid that he will make a moral judgement on you, remember that you are putting your life at stake if you practice unsafe sex. However, if you are economically dependent on your husband, or are afraid that he might abandon you or abuse you, then it may be difficult to bring up the subject of safer sex. You can seek help, advice and counselling from women's organisations and NGOs such as the Malaysian AIDS Council.

For more information on treatment and counselling, call the Malaysian AIDS Council at 1-800-881848 or 03-4045 1033.

*Names changed to protect WAO's client's confidentiality.
** Information from the Malaysian AIDS Council information booklets

Prepared by Jaclyn Kee and Rozana Isa
Women's Aid Organisation - 20 Years of Service to Women and Children

Fortnightly Column by WAO on Sunday Mail (Reprinted with permission from Sunday Mail)