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 Rising above tradition and living positively with HIV 


Health is a fundamental human right that has to be enjoyed by everyone. For an HIV positive woman, the drive to rise above challenges of living with the virus and live a normal life including bearing children is more challenging. 


Mwaale Astrida, 27, sits at the entrance to her home showing a six-month pregnancy while her two-and-a-half year old daughter plays on her laps.


Being married with only one child who was 11 years at the time, Mwaale faced pressure from her family to conceive another child. Unknown to them, she was coming to terms with an HIV positive diagnosis after testing in 2011. “In my tradition, it is not lawful for a married woman to have only one child and the HIV positive status made it worse for me - l reached a point where l felt l was not woman enough to fulfil tradition’s demand of having six children”.


Her family and her in-laws demanded to know why she could not bear a second child, considering the time lapse from her first child. “I almost quit treatment during that time and wished death would visit me as l did not know about the options l had for conceiving when l was HIV positive.”


Mwaale, who comes from Makalu Village in Kawambwa district, Luapula Province of Zambia, said she commenced on Anti Retro Viral Drugs (ARVs) after the HIV test as her CD4 count was very low. “Due to my low immune system, I was never counselled on how to adhere to treatment for my immune system to improve,” she adds.


“However, my life changed for the better when Kalambata Christopher a Community Action Group (CAG) member, under Action Africa Help Zambia (AAH-Z) visited my home during a weekly community follow-up meeting in 2014. He shared with me information on the new invasion of Option B+”.


Astrid Mwaale AAH Zambia.jpg

 Kalambata Christopher from the Community Action Group, under Action Africa Help Zambia (AAH-Z), visiting Mwaale at her home


Option B+ is a recommendation by the World Health Organization (WHO) to initiate all HIV-positive pregnant and breastfeeding women on antiretroviral therapy (ART) for life. It also recommends immediate initiation of all HIV-positive children younger than five on ART. Previously treatment to HIV-positive pregnant and lactating women depended on their HIV viral load levels and did not include a recommendation to remain on treatment for life.


Mwaale visited the health centre for more information before deciding to get pregnant with her second child. She was put on Option B+ during her pregnancy and had no complications during her pregnancy - her CD4 count rose from less than 200 to 1059. After successfully delivering a baby girl called Margaret, the child was tested for HIV at six weeks and tested negative. The test was repeated when the child turned 18 months and again at 30 months. On both occasions the results were negative. Mwaale is now six months pregnant with her third child and on Option B+. She thanks AAH-Z through the CAGs who still visit her home and provide counselling during the pregnancy.



We focus on eliminating new childhood HIV infections and reducing HIV related maternal deaths




AAH-Z is in partnership with Positive Action for Children Fund (PACF) implementing a community-led prevention initiative (COPI) project aimed at eliminating new childhood HIV infections and reducing HIV related maternal deaths. This is  being done by addressing loss to elimination of mother-to-child transmission of HIV (eMTCT) follow up through strengthening referral networks, increasing access to treatment for HIV positive mothers and their children during pregnancy and breastfeeding, and strengthening community engagement in eMTCT and maternal child health service delivery and monitoring.

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