Paper short abstract:

Prevention of HIV-transmission from mother to child (PMTCT) may be emergency or chance. Lesotho's Ministry of Health intends to prevent pregnancies in HIV-positive women as more economic way of PMTCT. Some HIV+ mothers, in contrast, see the program as chance for healthy offspring.

Paper long abstract:

Currently, about 23,3% (UNAIDS) of the population between 15-49 yrs in Lesotho are found to carry the HI-virus. Medication to prevent

HIV-transmission from mother-to-child (PMTCT) during pregnancy, delivery and

breastfeeding is available, however, preventing pregnancies of HIV-positive women is considered a cheaper way. Thus, although not specifically mentioned in the national ARV-treatment guidelines or in the HIV testing and counselling training courses for staff, in many cases HIV+ women are advised to prevent

subsequent pregnancies and are discouraged from notions of large families. Notwithstanding, Lesotho has currently one of the lowest total fertility rates

in Africa with 3,3 children born per woman already and the government intends to lower it even further. This is due to the governmental policy aimed at having a young generation that is HIV-free by reducing the possibility at the earliest possible stage. Yet, the national aids commission regrets that 24.4% of the women who knew about their HIV positive status still got pregnant. Even though,some health institutions even combine antiretroviral drugs, which are given to HIV-positive people, with contraceptives. In others, HIV-positive women are "counselled to the point of accepting contraceptives" (Fieldnotes).

I would like to show in this presentation, that some HIV+ women understand PMTCT rather as a chance than an emergency option like the government does: It is now much more likely to have a child being born free from HIV and the provision of PMTCT stimulates a desire for healthy offspring.