In terms of pregnancy we can't always reach these goals, but access to pre-diagnosis discussion with the mum about what she wants for herself and her foetus. In other words every patient in our hospital is treated as if she could have a fluid borne pathogen that could affect contacts - HIV mums are treated no differently to any other mother. This is a great comfort to everyone. Education and counselling is the centrepiece of our work. It is what we spend most of our time on in our very long and frequent discussions.
Empowerment is a very important part of our orientation.
This may seem altruistic of us, but it is actually quite practical - there is no way that you can force anyone to take therapy that she doesn't want to. All your going to do is to force her to tell you that she is doing what you want her to do. We find that when mothers know this, they are very honest in telling us about their adherence, about how many meds they really did miss that week. This can explain a viral laod that is inexplicably high and it really is an enormous boon to our relationship with individual and collective patients. But our treatment guidelines have evolved since the 076.