A Happy Marriage, A Terrible Secret, A Healthy Baby

Enlarge this image toggle caption Anders Kelto/NPR Anders Kelto/NPR

Phelokazi Tinzi met the man of her dreams at a barbecue.

She was 28 years old, and visiting her cousin in Cape Town, when her future husband approached her. "He told me I was beautiful, but I thought he was just saying that to every girl," she said. But she gave him a chance – and her phone number. A few weeks later, they were engaged.

They married in their families' ancestral land — South Africa's Eastern Cape, where subsistence farming is still the norm and cows are considered a form of currency. They had a traditional wedding in December 2011 — a sheep was slaughtered and eaten, alcohol flowed — and Tinzi was given a new name by her husband's family.

"The name was Asake," she said. "It means 'let her build us.'" The way Tinzi saw it, her new responsibility in life was to build a family.

The day after the wedding, Tinzi's husband revealed a terrible secret. "He told me he was HIV-positive," she said.

Tinzi was angry at her husband. He told her he was scared she would never have married him if she knew. She wrestled with the news for weeks and eventually decided to stay with him. After all, she thought, she had made a commitment — and she loved him.

A few months later, she went to the clinic for an HIV test. She got the results that same day. She was HIV-positive. "I thought now nothing in my life was going to be right, nothing that I have ever dreamed of would come true," she said.

But she still wanted to start a family. A few months later, she was pregnant. She assumed the baby would be born HIV-positive and simply hoped her child would live a long, healthy life with medication.

There was a lot Tinzi didn't know. HIV-positive women who don't seek medical care have roughly a 40 percent chance of passing the virus on to their child. But with proper medical care — and a steady dose of anti-retroviral drugs — that number can essentially be reduced to zero. The problem is, treatment isn't available in many parts of the world. And even if it is, women aren't always aware of the option.

Fortunately for Tinzi, when she began prenatal care, she was connected with mothers2mothers. The organization, which trains HIV-positive women to serve as "mentor moms" to other HIV-positive, pregnant women, operates in six countries in sub-Saharan Africa and has reached more than 1.2 million pregnant women in just over a decade. Kenya has incorporated it into the national health care system. Similar plans are underway in South Africa.

Tinzi's mentor in the Cape Town program was a woman named Funeka. "Funeka helped me accept my status and deal with it," Tinzi said. "But most importantly, she taught me that HIV is not a death sentence, for me or my child."

The two stayed in close touch throughout Tinzi's pregnancy. Funeka offered counseling and emotional support, and helped Tinzi navigate South Africa's sometimes confusing health care system. Tinzi put her full faith in Funeka, because she had lived through the same challenges.

"I decided that I would do anything she told me, to make sure my baby was HIV-negative," Tinzi said.

She took her medications, ate well and had regular prenatal checkups. She even began to enjoy being pregnant — something she had been unable to do before meeting Funeka.

About a year after learning she was HIV-positive, Tinzi gave birth to a baby boy. He tested negative for HIV.

"I was so happy I cried," she said.

Her husband, who was supportive throughout her pregnancy, was equally overjoyed. Tinzi said that staying with him was the right decision.

After their son, Mfihlelo, was born, Tinzi continued to receive advice and counseling from Funeka. Tinzi learned it was safe to breastfeed, despite her HIV-positive status, which was contrary to what some friends and neighbors said. Her son grew and stayed healthy.

Just after Mfihlelo's first birthday, Tinzi decided that she wanted to become a mentor mom, like Funeka. So she joined mothers2mothers. She now works five days a week at a clinic outside Cape Town.

The work can be frustrating. Some of the women she advises refuse to believe they are HIV-positive. Some stop taking their medication. Others simply disappear. And Tinzi said supporting so many women — often dozens at a time — can be emotionally draining.

But she loves what she's doing. "The best part is being with a woman who is in tears when she learns she is HIV-positive, but then has an HIV-negative child," Tinzi said. "She goes from crying with sadness to crying with joy nine months later."

It's a transition that Tinzi knows well.