The Times, Trenton, NJ 
Copyright 1998: The Times 

March 30, 1998, page 17

Dawn Day

New Jersey has 9,000 children who have lost their mothers to AIDS, and the number is expected to grow to 16,000 by the year 2001, according to a study sponsored by the New Jersey AIDS Partnership. By increasing access to sterile needles and drug treatment, New Jersey could do much to stop the spread of HIV and the creation of even more motherless children.

Twenty-six percent of all AIDS victims are women, and New Jersey leads the nation in the percentage of AIDS cases among women. Seventy percent of New Jersey women who test positive for HIV are between the ages of 20 and 39. These are the prime child-bearing years. 

The children left behind by mothers who die of AIDS are young; 65 percent of New Jersey's AIDS orphans are age 12 or younger. Many news stories about children and AIDS focus on the question of transmission of the HIV virus from the pregnant woman to her infant around the time of birth. Medical advances in this area have brought good news. 

With appropriate medical treatment during pregnancy, the lives of many infants are being saved. What is not generally known is that, even without medical treatment, most infants born to mothers with HIV/AIDS are not infected with the virus; in fact, about 75 out of 100 are born free of HIV. Given appropriate medical treatment for the mother during pregnancy and birth, the infant's chances of being born free of HIV disease rise to about 92 in 100. This improvement is substantial and important. 

But what is also important to note from these figures, when we are concerned with mothers dying of AIDS and leaving orphaned children behind, is that, throughout the period of the AIDS epidemic, most children born to HIV positive mothers have not been born HIV positive.

Other AIDS orphans are not HIV positive because they were born before their mothers were infected with the HIV virus. Even when both mother and child are HIV positive, given the advances in AIDS treatment, the HIV positive child can live on long after her or his mother's death.

Once our focus is on all children harmed by the AIDS epidemic and not just those at risk of HIV at birth, we must conclude that the harmful effects of HIV/AIDS epidemic on children are not declining but expanding. More and more New Jersey children are living through the devastating experience of watching their mothers sicken and die of AIDS.

The mothers these children are losing do not fit stereotypes. Assuming the women who have already died of AIDS are like the women who are HIV positive today, we can say that half of all these mothers never injected drugs. They were unfortunate in their relationships, infected because their husbands or significant others at one time injected drugs with an HIV-infected needle. 

Another 45 percent were infected through injecting drugs with an HIV-infected needle. Even here we need to be cautious in our assumptions. Women who inject drugs at one point in their lives are not drug users for life. Some experiment for only a short interval. Others use drugs for a longer period and then successfully stop. We have every reason to expect that recovered drug users are good mothers.

Drug treatment definitely needs to become more available in New Jersey. Education on the importance of using condoms must continue. But more accessible drug treatment and safe sex education are not the only weapons in the battle to control the AIDS epidemic in New Jersey. Another effective weapon in the area of HIV prevention is making sterile needles accessible to persons who inject drugs.

The science is overwhelming. Seven federally-funded studies have found that giving persons who inject drugs access to sterile needles DOES NOT increase drug use and DOES slow the spread of HIV disease.

New Jersey's AIDS orphans struggle to comes to terms with their loss. 

Children of mothers now infected with HIV and AIDS live with fear and insecurity. If these children could speak out, their message would be clear: "Why didn't you do everything you could to save our mothers' lives?" 

We cannot turn back the clock. There are limits to what our current AIDS medicines can do to slow the progress of HIV disease. But let us do all we can to prevent the spread of HIV's devastation to more children and more families.

On Wednesday, the New Jersey Governor's Advisory Council on AIDS, which came out in favor of increasing access to sterile needles two long years ago, will be hearing from two respected scientists on the AIDS epidemic in New Jersey and the United States. 

Come to their presentations. Learn how effective prevention through clean-needle programs and pharmacy sale of syringes can save thousands of additional children in New Jersey from the loss of their mothers.

The speakers will be Eric Goosby, M.D., of the Centers for Disease Control in Atlanta, and Sam Friedman, Ph.D., of the National Development and Research Institutes in New York City. The April 1 meeting will begin at 9:30 on the first floor of the Health and Agriculture Building in Trenton.

Dawn Day, Ph.D., is the director of the Dogwood Center in Princeton, New Jersey. Dr. Day is a sociologist and activist scholar who writes on issues of social justice and AIDS.