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Kate

Age at interview: 39
Brief Outline: Kate was diagnosed with HIV when pregnant with her second child. She has had two children after her diagnosis. Excellent antenatal care, caesarean sections and baby formula, instead of breastfeeding, ensured that there was no transmission of the virus from mother to babies. Her current antiretroviral therapy (ART) is Atripla and her CD4 count is 600.
Background: Separated, 3 children, works full-time. Ethnic background: Black African.

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Kate was pregnant with her second child in 200, when she was diagnosed as HIV positive. Her diagnosis came as a shock; she didn’t know when she was infected and had had no symptoms to indicate that something was wrong with her. For Kate it took time to accept her diagnosis and, for about two years she lived secluded from others. She finally came to terms with her condition when, through Terence Higgins Trust, she met another HIV positive woman who had lived with HIV for more than twenty years and also had a child after diagnosis. Listening to her made Kate realised that to be HIV positive was not a death sentence.
 
Kate’s husband at the time was tested and found to be HIV negative, and he found it hard to accept his wife’s positive diagnosis. The marital relationship became strained and family life changed for the worse. He started to emotionally abuse her and didn’t miss an opportunity to demean her. For a while, they lived in the same house, but had separate lives until Kate couldn’t cope any more with his hostility and left the family home.
 
Kate feels that support, information and counselling should be extended to the partner of the person diagnosed with HIV to enable them to understand and cope with the diagnosis. She thinks that lack of accurate information greatly contributed to her husband’s negative attitude towards her, and eventually towards the breakdown of their marriage.
 
As an HIV positive expectant mother, Kate was cared for and closely monitored by her HIV and specialist obstetric consultants. She got her HIV positive diagnosis while pregnant with her second child and she reluctantly agreed to start on medication; Zivoduvine and Kaletra. She was told that the baby would be caesarean delivered and that she would not be able to breastfeed. Emotionally, she found it hard to come to terms with both restrictions. During her third pregnancy, her viral load was undetectable and was told she could have a normal delivery but unfortunately, she got ill for the latter part of her pregnancy, vomiting and thus, affecting the absorption and effectiveness of her medication. She ended up having another caesarean. Both her children are HIV negative.
 
Kate’s current antiretroviral therapy is Atripla. Her CD4 count is 600 and blood tests show that the HIV virus is undetectable. In the past, she found it a struggle to take so many pills, at different times and with different instructions and kept slipping off her treatment. Atripla is taken once a day and Kate finds that medication no longer dominates her daily routine.
 
Kate has two children from her previous marriage and a third child with her current partner who is also HIV positive and on medication. Regarding relationships, she feels that it is easier to have a partner who is also HIV positive like herself. There is no need to explain anything or, risk being rejected because of the condition.  
 

Kate didn’t breastfeed her second son and felt that she missed out on the bonding experience that she felt she has had with her first child.

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Kate didn’t breastfeed her second son and felt that she missed out on the bonding experience that she felt she has had with her first child.

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But then they told me I had to do caesarean and all that, and not breastfeed, which was hard for me because…
 
Which one?
 
Knowing, knowing that I have to do caesarean, go for caesarean and not breastfeed my baby because I had my first one, child, and I breastfed him. Had a normal birth and everything so it was like everything is just changing.
 
Yeah, so how did you feel about the idea of not being able to breastfeed?
 
That hurts.
 
Hurts?
 
Yep and I just, I just, I don’t know even anything that is worse to me than that and because you know I felt like no breastfeeding to me is just a way of bonding with a child and it’s something that a mother should do. And I felt like, okay, the disease has robbed me of that opportunity to breastfeed my child, to be that close to him you know because it’s not the same as some men.
 
I can tell you that with my first child we are really, really that close, he’s a boy as well, we’re very close. But the other one, I felt like whether I’m there or not there, it doesn’t really bother him and sometimes I, I think about it that is it because of that  I didn’t breastfeed him because he felt a bit distant than other one. I don’t know if it’s just me honestly beating myself about it, knowing that, oh, well I didn’t do this or may be it shouldn’t have any effects on him, I don’t know. But…
 
Carry on, carry on.
 
I still wish there was a way that I could have breastfed him but anyway if it was for his own good then.
 

Kate talks about the kinds of help she got from her HIV support worker.

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Kate talks about the kinds of help she got from her HIV support worker.

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I think, you know, when you are a mother, they are, I’m, I’m the kind of person, maybe, they, they do a lot things like… like they’ll provide us with all the milk and appointments and maybe they can even make appointments for us. And they remind me because I’m, I think I was at the point where I was really stressed, couldn’t even remember sometimes what day it was and I wouldn’t even remember my appointments but you know. Or sometimes when I don’t have transport available they would even come, offer to come pick me and take me to the hospital and they would go sometimes with you to the hospital if you don’t want to be, go there on your own, they, they support and they know all of it. There is things that they can explain things to you if there’s things you don’t understand. They do a lot, I don’t want to…, they do, I mean and also if you want to meet up with other people they can organise it if you need someone else to talk to whose going through similar issues with you, so.
 
And did you meet other expecting mothers when you were pregnant with her or no?
 
Yes, I have. I have met a couple of ladies who were expecting about the same time as me.
 
Okay, so that was, kind of, was that reassuring, was that sort of, kind of supportive?
How did you feel about it?
 
Yes, this time round, like I say, I was, I was okay with it, you know. The first time I think that was a…. When you’re first time is when it’s harder because then you do not want to talk to people. You don’t want, even though there are people who are, you don’t want people to know that you are, I would say that you don’t want to be painted with the same brush as others, you just, even though you know that you’re HIV positive actually, it’s like I don’t want to be like them. It’s just, I don’t know if it makes sense.
 
Yeah, it does make sense, yeah.
 
Because I, it’ll be like, oh shall I talk to those people, or accepting them, accepting what, who, what you are, and I think it’s just sort of hard at the times like okay now I fe... now I feel like I belong to a second group of people who are like this and that and I didn’t want, I wasn’t ready to accept it. But this time, I just don’t mind honestly. I meet people there, we talk.
 
Okay and you go to the meetings organised by THT?
 
Yeah, yeah I do go to the meetings and meet other people. 
 

Kate says that in her community people suspect the mother is HIV positive if she has had a Caesarean section and does not breastfeed.

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Kate says that in her community people suspect the mother is HIV positive if she has had a Caesarean section and does not breastfeed.

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To be quite honest, the thing is like a lot of people, once you tell them your baby was a caesarean and you’re not breastfeeding, that’s it, they conclude the person must be HIV Positive. That’s just something that most people, like every, like most people that’s what they think and I mean, it’s not like I had very good like, natural birth. I had a very hard natural birth with my son because he was quite big and I really suffered. Maybe anything [laughs] I would have done to relieve that would have been nice but you know just the thought now of, ‘Okay, I just had, oh I could get away maybe with saying that I had a caesarean because of whatever but then I’m not breastfeeding either.’ And then I don’t know if you know but a lot of people, those two things, if you’ve had a caesarean and you’re not breastfeeding, that’s it, they, they conclude that you are HIV Positive, and…
 
What, did people ask why you are not breastfeeding?
 
Yeah, but I always had to make up stories isn’t it. Oh hey, de,de,de,da
 
What? You had cracked nipples or not milk or something like that?
 
Yeah, you say whatever or maybe say, “Oh, yeah.”
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