Preventing AIDS in Children

S. M. Rayhanul Islam
Thursday, June 8th, 2017


 

Despite enormous progress, the AIDS epidemic remains one of the major critical issues of our time. The situation is especially dire for children – and for adolescent girls most of all. AIDS is a leading cause of death of adolescents globally – and especially in sub-Saharan Africa. The UNICEF Report “For Every Child, End AIDS” indicates that over half of the world’s new infections last year (i.e. 2015) were among women, children and adolescents.

 

Every day, around 400 children become infected. Far too many children have dropped out of treatment, or never received it in the first place. To end AIDS in children once and for all, the Report argues, we need to focus on both treatment and prevention, with a deeper focus on the life cycle of the child, beginning during pregnancy, in infancy and childhood, and through adolescence.

 

The publication contains four main chapters including the chapter “Introduction”. The introductory chapter draws our attention for addressing some emerging challenges which can be the clearest path to success in ending AIDS. Children aged 0–4 years living with HIV face the risk of AIDS-related death compared with all other age groups. Another challenge is the number of adolescents living with HIV has increased by 28 per cent since 2005. With demographic trends indicating that the youth population is growing fast, the challenges posed by HIV will multiply if new infections among 15–19-year-olds are not halted.

 

Chapter-1 focuses on “Support over Lifetime”. People usually require support from systems that address their evolving needs: evidence-based public health policies; robust health systems that include supportive communities and compassionate health-care providers; educational systems that deliver quality learning; and equitable protection systems that safeguard the most vulnerable members of communities from violence, exploitation and abuse. Therefore an integrated service is essential to meet the needs of all people including women and children. HIV-integrated services delivered by the health, education and protection sectors are necessary for the efficient and effective implementation of HIV interventions and also contribute to broader development outcomes.

 

Chapter-2 deals with “Mothers and Children”. In 2015, an estimated 1.4 million pregnant women were living with HIV, of which more than 1 million received the most effective regimens of antiretroviral medications (ARVs) for prevention of mother-to-child transmission (PMTCT), with an estimated 79 per cent coverage in sub-Saharan Africa. Gains made in bridging the treatment gap among children are equally impressive. In 2009, approximately one in seven children living with HIV in the 21 Global Plan countries in Africa had access to antiretroviral therapy (ART).

 

In 2015, an estimated 150,000 children (aged 0–14 years) were newly infected with HIV globally, and nearly 85 per cent of them live in sub-Saharan Africa. The majority of these infections occurred during the breastfeeding period. The shift in the timing of HIV transmission from mother to child has created a new urgency for focusing on adherence to medicines and retaining mothers and infants in care to the end of the breastfeeding period.

 

Chapter-3 focuses on “Adolescents”. An estimated 1.8 million adolescents between the ages of 10 and 19 years were living with HIV in 2015, a total that is 28 per cent higher than the comparable estimate of 1.4 million in 2005.  This chapter suggests some strategies to accelerate progress for adolescents: i) Strengthen data collection and analysis to drive decision-making; ii) Invest in a combination of high-impact interventions to reach adolescents most at risk of HIV infection; iii) Prioritize efforts to address forced sex, sexual exploitation and loss of sexual agency among adolescent girls; iv) Analyze and respond to the needs of adolescent key populations; v) Educate adolescents about HIV; and vi) Apply implementation science to investigate effective operational approaches to bring innovations to scale.

 

The current situation of the AIDS in children response calls for innovation in implementation, dissemination and optimization, using what is known as a foundation to help focus new action. Ending AIDS in children will also require us to address the social and economic factors that continue to fuel the AIDS epidemic.

 

The writer is an independent researcher. E-mail: smrayhanulislam@hotmail.com

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