Pediatric HIV/AIDS
THE CHALLENGE
Each day, 1,500 children are infected with HIV; 90% of whom live in Africa. Child mortality is expected to double by 2010 in the areas most affected by the pandemic.
Early identification of HIV in infants is a major challenge. As a result, approximately 35% of HIV-infected children in Africa die by age one and over half die by age two. Moreover, stigma hinders many families from seeking HIV diagnosis, care and treatment for their children.
KEY INTERVENTIONS
There are many missed opportunities to identify and provide care and treatment for HIV—exposed and HIV—infected infants and children. PMTCT programs currently reach only about 10% of women who need them, and many do not ensure follow-up of mothers and infants after delivery. Moreover, children treated on hospital wards for malnutrition, repeated pneumonia, and other recurrent illnesses are often not suspected of having (and not tested for) HIV.Pediatric HIV/AIDS services are most effective when they are integrated-or at least linked-with other child survival interventions. Children infected with HIV, including those not yet receiving antiretroviral therapy, should be provided with cotrimoxazole at four to six weeks of age to prevent pneumonia and other opportunistic infections. Although it is estimated that this life-saving intervention could reach more than 4 million children each year for a cost of US $10 per child, it is not yet a priority strategy for pediatric HIV care in most countries.
Infants and children who meet clinical criteria should also receive antiretroviral therapy, adherence support, and continuing rapid management of common childhood illnesses and referral for care, as needed.
