Early Infant Diagnosis

For those of you living in the HIV world only through my stories, "Early Infant Diagnosis" refers to the concept of starting HIV positive infants on ARV medicines as soon as they are diagnosed positive, before they get sick. Over the past 2 years, more and more clinics in rural Swaziland have access to the test for infants, called a DNA PCR test. I have been spending some time collaborating with another NGO, called ICAP (Columbia University's International Center for AIDS care and treatment Program), which has been taking me to the rural communities. And I have the pleasure of telling you about my first rural ARV initiation on an infant, who was diagnosed when he was 2 months of age. The story is a bit hard to swallow, as his mother did everything right; tested in pregnancy, found out she was HIV positive, had her CD4 count drawn, found it was high enough to not need full ARVs but only one (AZT), took it, and gave the infant the right prophylactic medicines, and yet her child still turned positive. This still happens. We see it. But for now, we can do something about it. This mother has come to clinic every time I have been there (which is only twice a month), and after repeating the test, drawing labs myself (while teaching nurses), transporting ourselves the bloodwork to the nearest facility 30 minutes away, I finally, last week, started the child on ARVs. The clinic had the correct infant doses, and mom had been counseled and was ready. Baby steps....

And now a cultural story. Last weekend my colleagues and I got invited to a lobola ceremony. Our lab director is getting married. And her future husband's family paid her family 17 cows in order to marry her. Last weekend they delivered the cows to the homestead (only 12 cows, the remaning 5 are "coming"), and the family immediately slaughtered 2 cows for all their friends to enjoy. We admired the largest cooking pots we have ever seen, along with a large quantity of meat, that was eaten by all the invited guests.