By 25, Betty had four children. Her last delivery nearly killed her, when she lost too much blood. “I survived but never regained my health,” says Betty. “I was so tired, because I was always breastfeeding. I couldn’t help out in our village. I couldn’t even leave the house.”
Today, in two small huts in rural Uganda, Betty is raising seven children, all under the age of 13. She and her husband, Oscar, adopted their nieces and nephews—orphans who lost their father in a boating accident and their mother to HIV.
“Bonnie, Yvette, Isaac…” Betty begins naming her children, one by one. Five-year-old Omorvona hides shyly behind her brothers.
All seven children rely completely on Betty and Oscar. They survive on what little money and food Oscar makes as a maize farmer. They count on Betty’s love and her promise to keep them in school—their best hope for a better life.
That’s why the couple’s HIV diagnosis was so devastating.
STEP ONE: LEARN THE TRUTH
Oscar was at the clinic receiving treatment for malaria when he tested positive for HIV. At his doctor’s urging, he went directly home to tell Betty—who was pregnant—so she could get tested, too.
“The people at the clinic convinced him to tell me,” says Betty, gratefully. “He came home and said, ‘I have HIV. You need to get tested for our baby.’”
It wasn’t the first time Betty considered getting tested. “A few months earlier, I was at the clinic,” she says. “There was this health talk about HIV and family planning.” Betty heard that women with HIV could actually do something to prevent giving it to their newborns. “I almost got tested then.”
But it was Oscar’s news—the inescapable truth of it—that finally drove Betty back to the clinic. “I found out I was positive,” she says. That night, the couple sat down together. Imagine the extremely painful questions they asked themselves:
Did we give our children HIV?
About the pregnancy—how can we keep our baby safe?
Are we going to die?
Betty and Oscar promised to do whatever they could to protect themselves and their children. But they needed help.
STEP TWO: TAKE ACTION
The family was not alone. Thanks to the Arise project, they had a strong support system in place.
When Betty and Oscar returned to the clinic for treatment, they were greeted by a host of remarkable providers—the HIV case manager named Polly, who uses her own experience living with HIV to counsel others. The midwife named Judith, who says it’s her life’s mission to keep babies healthy.
Right away, Betty enrolled in a program for pregnant women with HIV (According to the World Health Organization, without antiretroviral drugs, Betty faced a 15-45 percent chance her child would be infected. But if she followed this program, which included a regimen of antiretrovirals, she could reduce that risk to less than 5 percent).
Then the couple had their children tested. They waited for the results.
Today, five years have passed. Betty and Oscar sit close on a mat in front of their hut, sharing their inspiring story. Betty smiles radiantly—“All of our children, even our youngest, are free from HIV.”
Betty and Oscar want to keep it that way. They want their children to be safe. To have food and education, even when poverty grips them tightly. They need to keep everyone—including the children’s only mother—healthy. That’s why they choose to use contraception.
STEP THREE: MAKE A CHOICE
Once a week, a “community support agent” named Dennis navigates the winding, overgrown footpath that leads to Betty and Oscar’s home.
“My job is to reach out to people, like Betty and Oscar, with information about family planning and safe sex,” says Dennis. “I counsel them regularly in their home and refer them to the health facility for services.”
Dennis is uniquely qualified—as a person living with HIV and a Pathfinder-trained counselor. Not only that, he grew up in the community he serves. He has known Oscar for years.
“We felt comfortable to disclose our HIV status to Dennis,” says Oscar. “Then he was the one who told us about family planning.”
“Before Dennis visited us, we’d heard a lot of things about family planning,” says Betty. “But they were all wrong. Things like—if you use family planning, you just keep bleeding. Or if you get an implant in your arm, it will float under your skin, all the way up into your back. Also, we didn’t know all the ways family planning could help us. Dennis told us the truth.”
Empowered with information, Betty and Oscar began using contraception. To this day, they are overjoyed with their decision.
For Betty, it was a matter of life or death.
“Before, the doctor told me if I continued giving birth, I might not survive,” she says. “But because of family planning, I am here. I am healthier. And I can do more things to take care of my family, like work in the garden.”
Contraception allows Betty to be the woman she always wanted to be. “People can see how much healthier I am, that I am not always sick. So if there are problems in my community, they come get me,” she says, proudly. “They know I can help now.”
Oscar points to his children across the dusty yard. They smile back at him—big genuine smiles. “All HIV free. And all going to school,” says Oscar. “We feel good.”
Arise—Enhancing HIV Prevention Programs for At-Risk Populations is implemented by Pathfinder International and National Community of Women Living with HIV and AIDS. With support from PATH and Foreign Affairs, Trade and Development Canada (DFATD), Arise implements innovative HIV prevention initiatives for vulnerable communities, with a focus on determining cost-effectiveness through rigorous evaluations.