'I don't want my boy to be positive': pregnant women face sky-high viral loads as cuts hit HIV care in Africa

[milestogo]

As the withdrawal of US funding disrupts treatment and halts crucial research in South Africa, clinics fear the resurgence of mother-to-child transmission of the virus

Last modified on Mon 16 Jun 2025 21.31 EDT

Zola Madikane* was born HIV positive in 2004. Put on antiretrovirals (ARVs) as a baby, she has been on the life-saving medication ever since and has lived a normal life. No longer. “Now, I have a problem,” she says. For most of her life her viral load (the amount of HIV in her blood) has been undetectable. “When I went for my February clinic visit, I didn’t get my pills. They told me ‘shortage of staff’ and ‘come back another day’. I came back a few times, but it was the same story.”

Madikane, who is seven months pregnant, took no ARVs in March or April. She finally managed to get a batch in mid-May but by then her viral load was sky high. “It has never been high like this,” she says. “It is too risky for my unborn baby.” The risk of transmitting the virus to her child during delivery or while breastfeeding is much higher if her HIV is detectable. “My fear is that I will get sick more, I will get other infections like TB. And my fear for my baby is too big,” she adds. “I don’t want my boy to be positive.” Madikane knows first-hand the mental struggles of growing up with HIV: “At school they teased me,” she says. “They would say, ‘You are positive … Why are you always going to the clinic? Why are you eating pills?’”

Sister Sibongile Mqaba, who has worked in the same clinic in Cape Town for 32 years, is hopeful that Madikane will get her viral load down before she delivers. But Madikane is not the only patient struggling to get treatment since the suspension of most Pepfar (President’s Emergency Plan for Aids Relief) funding to South Africa. Since initial cuts in January, US president Donald Trump has made further significant reductions. South Africa’s health minister, Aaron Motsoaledi, has complicated matters by insisting that the country’s HIV programme is “not collapsing” and assuring the public that there is no shortage of ARVs.

While it appears US funding cuts have not significantly dented ARV supply, Madikane’s story illustrates that access to treatment is about more than pharmaceutical supply. The abrupt stop-work order issued to Anova Health Institute, the largest recipient of Pepfar funding in South Africa, on 25 January meant that her local clinic didn’t have sufficient staff to meet patient demand on the days she visited.

https://www.theguardian.com/global-development/2025/jun/16/i-dont-want-my-boy-to-be-positive-pregnant-women-face-sky-high-viral-loads-as-cuts-hit-hiv-care-in-africa

[Solly Mack]

1. K&R

[Skittles]

2. the "pro-life" party DOESN'T GIVE A DAMN

NOPE