任何母親都不應該在她的孩子挨餓或感染愛滋病毒之間做出選擇
在烏克蘭，許多母親缺乏預防母嬰傳播所需的配方奶和藥物。 我們絕不能讓這場戰爭毀掉幾十年的進步
資料來源：Olena Stryzhak/衛報/財團法人台灣紅絲帶基金會編譯
戰前，烏克蘭正計畫申請世界衛生組織的證明，宣告該國已結束母嬰艾滋病毒傳播。
照片：Omar Marques/Getty Images
全球愛滋病防治計畫的發展得到比爾. 梅琳達. 蓋玆基金會的支持
幾個世紀以來，母乳喂養一直被認為對嬰兒的發育很重要。 但是，如果您需要母乳喂養您的孩子，而這樣做可能會傳播病毒怎麼辦？ 自俄羅斯 2 月入侵以來，這一直是烏克蘭許多感染愛滋病毒的母親的現實。 該國許多被佔領和以前被佔領地區的衛生系統已經崩潰。
缺乏配方奶意味著無法再獲得抗反轉錄病毒療法 (ARV) 的母親不得不母乳喂養嬰兒，從而增加了母嬰傳播的風險。
任何母親都不應該在她的孩子挨餓或感染 HIV 之間做出選擇。 2000年，我發現自己感染了愛滋病毒並懷孕了。我沒有得到必要的治療，但我很幸運生下了一個健康的、沒有感染愛滋病毒的嬰兒。
遺憾的是，情況並非總是如此。 世界衛生組織 (WHO) 建議，如果 HIV 呈陽性的母親能夠每月接受 ARV 治療和病毒載量診斷，則可以進行母乳喂養。 對於目前在烏克蘭感染愛滋病毒的新媽媽來說，許多人別無選擇。 戰爭摧毀了烏克蘭的醫療保健系統：700 多個醫療機構遭到襲擊，無數醫護人員和患者流離失所、受傷或死亡。
開戰前，烏克蘭衛生部正計畫向世界衛生組織申請證明，宣告該國HIV母嬰傳播終結。 這場令人心碎的戰爭很可能會阻止這一成就的實現。 2001 年，烏克蘭的母嬰愛滋病毒傳播率達到 27.8%，但到 2021 年已降至 1.3%。 2023年發布新數據時，很可能會大幅增加。 儘管近年來在對抗愛滋病毒方面取得了顯著成就，但烏克蘭的愛滋病毒疫情在東歐和中亞地區位居第二。
婦女迫切需要政府和人道主義團體的幫助，以對抗烏克蘭下一代嬰兒感染的愛滋病毒。但在獲得處理感染 HIV 的母親病例和預防母嬰傳播方面具有足夠經驗的醫護人員的機會——且在沒有污名和歧視狀況下——等等措施的缺乏，尤其是在烏克蘭西部地區，那裡有許多國內流離失所者。
母親及其嬰兒也需要抗反轉錄病毒藥物、基本藥物、衛生用品和食品。 我們已經能夠透過我的組織 The Positive Women 提供這些服務，但它並沒有涵蓋所有方面
全球對抗愛滋病、結核病和瘧疾基金向烏克蘭提供了 1500 萬美元（1250 萬英鎊）的緊急資金，並提供了挽救生命的藥品、設備和用品——包括為斷電的衛生設施供電的發電機。 Positive Women 還獲得了全球基金的資金，用於為婦女及其子女提供關懷和支持。 然而，還需要世界各國政府和組織提供更多幫助。
我們有責任幫助無聲和弱勢群體。 我們絕不能讓這場戰爭毀掉烏克蘭數十年來在對抗愛滋病毒母嬰傳播方面取得的進展。 我們必須保護兒童免受病毒感染，尤其是當我們擁有預防病毒的藥物時。
值此世界愛滋病日，請關注烏克蘭和世界其他國家遭受苦難的弱勢群體，幫助我們以更健康的方式迎接 2023 年。
Olena Stryzhak 是烏克蘭積極女性組織的主席
No mother should have to choose between her baby starving or being infected with HIV
Olena Stryzhak/The Guardian
In Ukraine many mothers lack the formula milk and drugs needed to prevent mother-to-child transmission. We must not allow this war to undo decades of progress
Before the war, Ukraine was planning to apply for a WHO certificate declaring the end of mother-to-child HIV transmission in the country. Photograph: Omar Marques/Getty Images
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For centuries, breastfeeding has been seen as important to a baby’s development. But what if you’re faced with needing to breastfeed your child, while doing so could pass on a virus? Since Russia invaded in February, this has been the reality for many mothers living with HIV in Ukraine. The health systems in numerous occupied, and previously occupied, areas of the country have collapsed.
A lack of formula milk means mothers who no longer have access to their antiretroviral therapy (ARV) are having to breastfeed babies, heightening the risk of mother-to-child transmission.
No mother should have to choose between her baby starving or being infected with HIV. I found out I was HIV positive and pregnant in 2000. I did not have access to the necessary treatment, but I was fortunate to give birth to a healthy and HIV-free baby.
Sadly, this is not always the case. The World Health Organization (WHO) recommends that HIV-positive mothers can breastfeed if they have access to ARV treatment and a viral load diagnostic each month. For new mothers with HIV in Ukraine at the moment, many do not have any choice. The war has devastated Ukraine’s healthcare system: more than 700 health facilities have been attacked and endless numbers of healthcare workers and patients have been displaced, injured or killed.
Before the start of the war, the Ukrainian Ministry of Health was planning to apply for a certificate from WHO, declaring the end of mother-to-child HIV transmission in the country. This heartbreaking war is likely to stop that achievement in its tracks. In 2001, mother-to-child HIV transmission reached 27.8% in Ukraine, but by 2021 had dropped to 1.3%. When new data is released in 2023, it is likely to have increased tremendously. Despite remarkable achievements in combatting HIV in recent years, Ukraine has the second-largest HIV epidemic in eastern Europe and Central Asia.
Women desperately need help from governments and the humanitarian community to combat HIV being contracted by the next generation of babies in Ukraine. Access to healthcare workers with sufficient experience handling cases of HIV-infected mothers and preventing mother-to-child transmission – without stigma and discrimination – is lacking, especially in western parts of Ukraine, where there are numerous internally displaced people.
ARVs, basic medication, sanitary kits and food are also needed for mothers and their babies. We have been able to provide these services through my organisation, The Positive Women, but it doesn’t cover everything
The Global Fund to Fight AIDS, Tuberculosis and Malaria gave Ukraine $15m (£12.5m) in emergency funding and provided life-saving medicines, equipment and supplies – including generators to power health facilities cut off from electricity. Positive Women also received Global Fund money to provide care and support for women and their children. However, more help is needed from governments and organisations around the world.
We have a duty to help voiceless and vulnerable people. We must not allow this war to undo decades of progress in fighting mother-to-child HIV transmission in Ukraine. We must protect children from contracting the virus, especially when we have the medicines to prevent it.
This World Aids Day, cast your minds to those vulnerable people suffering in Ukraine and other countries around the world and help us make a healthier start to 2023.
Olena Stryzhak is the chair of the Ukrainian organisation Positive Women