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The transmission of human immunodeficiency virus (HIV) from infected mothers to babies is not as common as many believe, experts say.
The University of Indonesia (UI)'s Noronyo Wibowo and Cipto Mangunkusumo General Hospital (RSCM)'s obstetric and gynecology department say even without intervention, the prevalence of such transmissions never exceeds 40 percent.
"With the use of antiretroviral therapy, elective caesarean section and by not breastfeeding, the prevalence is further suppressed to between 2 and 3 percent only," he said here Saturday at the 2008 Clinical Research Meeting on HIV/AIDS.
The meeting was organized by the Association of Indonesian Physicians Concerned about HIV/AIDS and was attended by experts and physicians from hospitals, community health centers and penitentiaries providing HIV/AIDS treatment across the country.
Noroyono explained the small prevalence was due to HIV's inability to easily penetrate placental barriers, in addition to high levels of the progesterone hormone during pregnancy.
Inflammations and co-infections, however, enable the transmission process, with its leading factor being viral load in maternal blood, he said.
He emphasized the importance of inflammation and co-infection prevention during medical treatment for pregnant women with HIV/AIDS.
"Without inflammation, we can almost say babies will be resistant to HIV," he said.
The number of people living with HIV/AIDS in Indonesia has increased from between 90,000 and 130,000 in 2002 to between 190,000 and 210,000 in 2006, according to official figures.
According to Kusumayanti from RSCM, the number of women in her hospital living with HIV/AIDS increased from 16 percent in 2004-2005 to nearly 24 percent in 2006-2007.
In line with this, she predicted the number of pregnant women with HIV/AIDS and the number of HIV pediatric patients would increase as well.
Kusumayanti said HIV positive men are mostly infected through needle sharing among intravenous drug users, while women are usually married and infected through sexual intercourse with their husbands.
According to Srimpi Indah from Pelita Ilmu Foundation, which is behind the community-based Preventing of Mother-to-Child HIV Transmission program in Jakarta, pregnant women with HIV/AIDS need psychiatric therapy in addition to standard medical care.
She said such women had the worst psychological states among all people with HIV/AIDS because they were not just distressed, angry and disappointed with their husbands, who generally pass on the virus to them, but also because they felt guilty for transmitting the same virus to their children.
"Emotional distress threatens their response to therapy. HIV causes distress and that worsens the condition of HIV/AIDS sufferers," said Srimpi, adding the problems needed proper addressing.
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