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Personal Story

Breastfeeding in the Era of HIV Undetectable Equals Untransmittable

February 17, 2017

Tuyishime Claire Gasamagera

Tuyishime Claire Gasamagera (Courtesy of Tuyishime Claire Gasamagera)

One time I was about to take a nap and overheard a conversation my three-year-old niece was having with her friends. My niece knew that she couldn't take her friends (aged three to five) into the living room unless they were supervised by an adult because they might make a mess, thus she took them to sit outside, right next to my bedroom window, and I could hear their conversation.

One of the kids started, "Did you know my dad has a big car?" The second said, "My parents bought a new TV." All the kids shared exciting things their parents had. Finally, it was my niece's turn, and we didn't have new, exciting things, thus she said, "My mum has big boobs with delicious milk; she can feed all of you."

I woke up because my niece in her childish innocence was sharing sensitive information. I didn't want to interrupt them; I simply looked out the window and could see my niece's triumphant face as she shared something she had that the other kids didn't, as all were no longer breastfed. And, I saw my nieces' friends rolling their eyes, saying, "Wow."

During dinnertime, I talked about this incident with my sister, and my niece was not ashamed to run into her Mum's arms requesting to be breastfeed. While taking her natural meal, fondly touching her mums' boobs, she proudly narrated the story, and her Mum was disturbed and said, "Honey you want the entire village to know that I have big boobs, really?" And my niece proudly responded, "Yes," by nodding her head." It was a funny story and was over.

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At that time, I was reminded that as a woman living with HIV, I may have boobs, I may have all it takes to have a baby, but the journey of having a child was complicated. In additional to that, the community and the medical world were not supportive, because for women living with HIV, desiring to have a baby was considered to risk infecting an innocent child and being super selfish.

As a child born with HIV, I am always haunted by the fear of bringing a baby infected with HIV into this world because my journey as a person born and growing up with HIV was not easy. I sobbed that night, thinking about my niece's pride in her Mum's boobs' natural milk. That night, I prayed to God to make it possible for me and for other women living with HIV to naturally have kids.

The day I dreamed of is now here; we have the tools for women living with HIV to naturally have safe babies: Undetectable equals untransmittable.

I am aware that it's a new discovery, and some of us who have lived longer with HIV may find it impossible to believe that when they take their antiretroviral treatment well and maintain an undetectable status, the risk of transmitting HIV is zero.

Breastfeeding is a natural, shameless way of feeding babies, and women living with HIV like me now have the opportunity to experience that privilege because U=U.

Our fight as an international community of people living with HIV is to ensure universal access to HIV treatment by addressing all barriers preventing all people living with HIV from accessing HIV treatment.

In our diversity, we should unite and be the champions in spreading the good news that U=U and we can end the AIDS epidemic if only all people living with HIV have access to HIV treatment, because science has proven that HIV treatment is HIV prevention and U=U. HIV science is on our side; we should use it to end HIV stigma, discrimination and criminalization.

HIV science proves antiretroviral treatment works. Utilizing HIV science and promoting human rights by ensuring that people living with HIV have access to such treatment and reach an HIV undetectable status so they can enjoy their sexual reproductive health rights are key elements to ending the AIDS epidemic.

The medical world, HIV scientists and pharmaceutical companies have a moral responsibility to omit to commit the same mistake they did in the late '80s when they failed to inform the public that AIDS is caused by a virus (HIV) that can be prevented and treated, allowing the public to be misled by fear-spread misconceptions that AIDS is a disease for people with questionable behaviors and low moral values. That unfounded fear of HIV and AIDS resulted in HIV stigma, discrimination, ignorance, indifference and criminalization of people living with HIV.

As women living with HIV, we are committed to staying on top of the game when it comes to HIV science, and we are spreading the precious knowledge that undetectable equals untransmittable In the era of U=U. United as people living with HIV in all our diversity with our allies, we can end new cases of babies born with HIV, and women living with HIV can naturally have babies and utilize their boobs to breastfeed their babies.

Tuyishime Claire Gasamagera is a motivational public speaker, life skills coach and visionary operations executive; fluent in over seven languages including English, French and Kinyarwanda; anti-AIDS activist, freelance writer, lobbyist and consultant with solid experience managing all levels of projects including fundraising, advocacy, budgeting and administration on the national, regional and global level.

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