Nikki Lee <[log in to unmask]> wrote:

> After the research that she described, and her descriptions of the
> speculations and the half-baked decisions by governmental authorities, I
> suggest that every pregnant woman absolutely refuse HIV testing. And refuse
> to have the baby tested as well.
> 
> One example was of the mother that had 5 HIV tests; 2 were positive, 2 were
> negative, and 1 was ambivalent. If babies are tested before 16 months, odds
> are that the HIV test will reflect the mother's HIV status. Another thing is
> that while fragments of HIV have been found in human milk, there seems to be
> no evidence that those fragments are infectious. This is like Hepatitis B
> and C; while fragments of the virus have been found in human milk, it is
> safe to breastfeed because the milk is not infectious.

Hi Nikki,

You make points about breastmilk and HIV here; however, I don't
understand why you are generalising that to talk about testing in
pregnancy, and why you are making a pronouncement that each and every
pregnant woman should refuse HIV testing (as opposed being presented
with accurate information and making her own decision).

It is my understanding that HIV treatment during pregnancy significantly
reduces the risk of the child contracting and dying from HIV/AIDS. This
is a wholly separate matter from the issue of testing in breastfeeding.
It is also a separate issue from the inaccuracy of testing in infants
(an issue which has been well known and described in the medical world
for a very, very long time). The fact that very early testing is
inaccurate doesn't mean that vertical transmission of HIV is a
fabrication. 

There is also the matter - again, completely separate from the above
issues - of breastmilk itself potentially not containing infectious HIV
particles, but blood from nipple or ducts being well and truly
infectious. While the babe may need to have an open lip or mouth lesion
or compromised gut to be infected, these conditions in infants aren't
exactly nonexistent. I am not proclaiming that mothers with HIV should
never breastfed - we know well that at least in certain conditions it is
far safer to be breastfed than to be bottle fed - but that there is a
lot of room for a nuanced discussion. 

Lara Hopkins

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