Bang-orn is a veteran HIV/Aids counselling nurse from Chaiyaphum. She has had sleepless nights lately because she can’t get Nid out of her mind. Nid was sent to Bang-orn after she was tested HIV positive in her early months of pregnancy. To prevent her baby from getting the virus, Bang-orn advised Nid to take AZT anti-retroviral drugs. But Nid refused because she didn’t want her husband or anyone to know about the virus.

Nid never showed up at the hospital again, nor does she allow hospital staff to visit her home. At a loss, Bang-orn raised this issue at a meeting of health professionals and social workers in Bangkok recently.

Instead of getting an answer, Bang-orn’s question sparked more debate.

Sivaporn from Samut Prakarn Hospital echoed Bang-orn’s dilemma. Worse, she also has to deal with infected mothers failing to bring their new-born babies back to the hospital for blood tests and treatment.

The Public Health Ministry has boasted of its huge success in reducing mother-infant HIV transmission. From an approximate 15,000 children born to HIV-infected mothers every year, only 1-3 per cent contract the virus from their mothers, compared to 30 per cent before AZT drugs were dispensed to both mothers and babies in the early 2000s.

While anti-Aids groups observe an increase in new infections in nearly every sector of society, and chiefly among teenagers in the past few years, the Public Health Ministry is still clinging on to its success in controlling mother-infant transmission. However, activists now question if the success story is real considering the case of Nid and many other women who are not covered by the health programme and thus disappear from the government records.

“From common sense you would think the mother would do every thing she could to protect her child, so why not commit herself to the medication that could prevent the transmission?” Sivaporn asked before adding: “But in fact there are deeper sociological issues be they gender, economics or social discrimination.”

Opinion surveys amongst rural women reveal that many of them still see their role as secondary to men. They have to provide sex when needed and help men build families by providing them with healthy children. But men think that household and child issues are not their business.

“That’s why you see pregnant women go to hospital alone and become very nervous when they find out they are HIV positive, despite the fact that they may have got the virus from their husbands,” Sivaporn said.

The increasing rate of infections especially among teenagers could see more young mothers refusing to take HIV drugs and stop visiting hospitals because they don’t know how to handle their lives.

A health counsellor from Udon Thani said three 14-year old pregnant girls were sent to her after they were tested HIV positive. “Now they have all given birth, we don’t know if the babies are infected because they have disappeared,” the counsellor said. “But we are soliciting for milk to feed many other babies born to HIV mothers. The government only provides milk to infants up to a year, but these babies are weaker than normal and their mothers are incapable of providing enough food to feed them.”

Activist Vasan Jareimphan from Raks Thai Foundation in Udon Thani suggested that Aids control may be more than gathering showcase figures; it involved many other aspects of a patients’ life.

“After all these stories of what people face in real life, I want to ask if we have really controlled Aids?” he said.