Guardian examines rise of pregnancies among HIV-positive women in Malawi

London's Guardian on Saturday profiled Grace Mathanga, an HIV-positive pregnant woman living in Malawi whom the newspaper first profiled five years ago.

According to the Guardian, an increasing number of HIV-positive women in Malawi are "knowingly getting pregnant" because of improved access to antiretroviral drugs to prevent mother-to-child transmission. However, the rising number of HIV-positive pregnant women in the country has created concerns about MTCT, as well as the risk of death for women, the Guardian reports.

Despite improved access to antiretrovirals in the country, testing for MTCT has been "much slower" throughout sub-Saharan Africa, according to the Guardian. Last year, 284,000 pregnant women who visited prenatal clinics were tested for HIV in Malawi, and of the 26,000 found to be HIV-positive, 19,000 were given antiretrovirals to take at the onset of labor. In addition, health center records indicated that only half of the infants, or 13,000, were born in maternity units that provided the drug nevirapine to prevent them from contracting HIV. Kelita Kamoto, the Ministry of Health's head of HIV/AIDS, said many women do not return to clinics after giving birth. "They are lost to follow-up," Kamoto said. Consequently, many infants are born HIV-positive, the Guardian reports.

Erik Schouten, technical adviser in the government's HIV/AIDS department, said the increasing number of HIV-positive women having children has generated disagreement between some health workers who say "there is a risk" and others who "say you should have a right to have children." Schouten added, "What we see at a professional level is people going back to normal life and having sex and thinking about families and the future."

According to the Guardian, Malawi has the third-highest maternal mortality rate worldwide. Tariq Meguida, consultant obstetrician at a government-run hospital in Bwaila, said, "In the end, there is little doubt that women die in Africa because they are poor -- really, really poor -- and voiceless. They say absolutely nothing. They are women and that is why they die like that. It is a huge, huge scandal. The world knows it and could do more" (Boseley, Guardian, 6/7).