Canadian program provides care to HIV-positive pregnant women, aims to reduce mother-to-child transmission

The CP/Yahoo! News on Tuesday examined the Positive Pregnancy Programme, a Canadian initiative created to provide HIV-positive pregnant women with care, resources and support.

Jay MacGillivray, a midwife with Sages-Femmes Rouge Valley Midwives, started the program in 2005 with Mark Yudin, an ob-gyn with additional training in reproductive infectious diseases. Under the program, pregnant women living with HIV/AIDS are provided with care during pregnancy, labor and after. The women are guaranteed that they will be attended by specialists and clinicians who are used to working with HIV-positive patients.

MacGillivray said, "There are people who are up-to-speed and compassionate and wonderful and clinically terrific who are nurses, but not everybody is comfortable with HIV." She added that she arranges for the pregnant women to receive future health care for their children and additional support from HIV/AIDS service organizations. "I become the string that draws it all together. I will see her prenatally, try and normalize her pregnancy for her -- because she's thrilled to be pregnant, but she's going to find people all the way through who, if they knew she was positive, would be horrified," MacGillivray said.

According to the CP/Yahoo! News, the program does not receive any special funding and has gained international attention. Requests from places such as London, Paris, Scotland, Cameroon and Botswana have been made to MacGillivray to help launch similar initiatives. "Our hope is that eventually we can use it as a transferable model" and that organizers "can boost enough reality and enough clinical competence in enough places that we can use it as a template elsewhere."

According to the CP/Yahoo! News, pregnant women living with HIV/AIDS who receive the proper medical treatment throughout their pregnancies have a less than 1% risk of passing the virus to their infants. A lack of medical treatment can lead to a 30% risk of mother-to-child transmission. According to the Canadian Pediatric AIDS Research Group, approximately 150 to 175 infants are born to HIV-positive women annually in Canada. MacGillivray said that concerns about how they will be treated prevent many HIV-positive women from seeking medical attention, making them instead turn to high-risk home births.

Yudin, who is conducting research into physicians' attitudes toward HIV-positive people having children, said that there is a stigma associated with HIV-positive pregnant women and that more than 75% of the women he sees are immigrants from Africa. He said many of them are "middle class or better, are working, have a stable relationship, have a stable job. I think the general public might not get that" (Burgmann, CP/Yahoo! News, 9/30).