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  • Title: AIDS and women's health care in developing countries.
    Author: Van Roosmalen J, Reynerse MM, Wiebenga JE.
    Journal: Trop Geogr Med; 1992 Jul; 44(3):284-5. PubMed ID: 1455539.
    Abstract:
    Infection by the human immunodeficiency virus (HIV) in sub-Saharan Africa affects the whole population of reproductive age. Women are affected as frequently as men, and children born of HIV-positive women are at great risk of contracting AIDS or becoming orphans in early life. The risk of AIDS infection is higher in persons having other sexually transmitted diseases (STDs), especially genital ulceration. Effective prevention and management of all STDs would contribute to fighting the HIV epidemic. The incidence of HIV-positive pregnant women reaches 30% in some communities. In view of a perinatal transmission rate of 1 in 3, infant mortality is estimated to increase by 10% on account of AIDS alone. However, perinatal transmission might be less effective and is estimated to be 39% in Europe. Pregnancy is an 'immunosuppressive disorder', and the number of T4-helper cells drops in normal pregnancy. In HIV-positive pregnancy these cells do not rise before birth. Perinatal transmission has been demonstrated to be much more efficient when the number of T4-cells drops below 400. Transfusion with HIV-positive blood is the most effective mode of transmitting AIDS. Autologous blood transfusion in the 3rd trimester of pregnancy is recommended when testing blood is impossible. Maternal mortality as a result of AIDS has not been frequent, but data from an obstetric service is Malawi confirmed that 31 maternal deaths out of a total of 73 in 1990 occurred in HIV-positive women. Theoretically, in female circumcision the genital scaring and dyspareunia may lead to genital ulceration and anal coition, which are co-factors in HIV transmission. High priority should be given to a comprehensive program to combat STDs including AIDS in view of the HIV epidemic.
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