World AIDS day: what about children? – Visualeyed
D-Stories | Society

World AIDS day: what about children?

Children and adolescents between 0 and 19 with HIV are often forgotten. On the occasion of the World AIDS Day, these are the updated figures from UNICEF.

Since 1988, the first of December of every year is devoted to the World AIDS Day.

It was established to take stock of the disease, of the therapy, and of the future research developments periodically. Since its creation, it has represented a precious moment to sensitize and inform the world population against this virus.

What is AIDS?

The acquired immunodeficiency syndrome, commonly known as AIDS (English acronym), is a disease that affects the human being’s immune system, debilitating it and making its defensive action against infections and external pathogens less efficient. 

According to the estimate of UNAIDS – the United Nations’ program to fight AIDS/HIV –, about 1,7 million people have contracted HIV in 2019; the lowest number of new infections ever registered since 1989. Yet, figures concerning one of the weakest categories of the population – children – are still alarming.

Even though several countries are making progress, many others still are not able to adopt tested methods to prevent HIV infection, especially when children are concerned. The Global Plan of the United Nations has triggered a significant improvement all over the world, reducing by 60% new HIV infections among children in 21 of the Sub-Saharan African countries with the highest load. But there is still a lot of work to do.  

According to data from the Unicef’s survey “Children, HIV and AIDS” of December 2019, approximately 2.800.000 children and adolescents between 0 and 19 in the world have HIV, among them 360 thousand represent new diagnoses. The virus’ global diffusion is not homogeneous: most of the affected children are indeed in Africa, especially in East and South Africa. In these regions, on average 1.800.000 children and adolescents have HIV, while in North Africa and in the Middle East the numbers plunge to 6.100 cases. However, no country in the world can consider itself free from the problem, even though the African continent is the most affected.

Every part of the world can resort to various options to limit the spread of the virus, especially when the youngest are concerned.

Most children contract the virus from their mother during pregnancy, birth, or breastfeeding. It is called " vertical transmission" or "mother-to-child transmission": a difficult inheritance, since the life expectancy of seropositive children is between 6 months and 3 years without an adequate antiretroviral therapy. 

Even though the Unicef report shows a marked improvement in the number of HIV infections in children between 0 and 9, new infections contracted in the perinatal period (the period immediately preceding and following the birth of the baby) remain particularly high – around 80.000.

It is possible to prevent perinatal transmission and to treat the disease even in the youngest patients, but what is needed are adequate prevention services and, above all, reliable tests that allow to act rapidly .

The probabilities that an HIV-positive mother transmits the virus to her child are between the 15 and 45%.

In the first and third trimester of pregnancy, therefore, it is pivotal that the mother gets tested for HIV to diagnose the infection as soon as possible and begin the antiretroviral therapy (ART) to reduce the viral load. The risk that a woman with HIV transmits the virus to her child can be reduced to 5% or less with an efficient therapy during pregnancy, birth, and breastfeeding; infants’ prophylaxis, together with formula milk, furtherly protect infants, lowering the risk of vertical transmission to nearly 0%.

Data show significant disparities as far as access to treatment is concerned: from the 91% in South Asia, 73% in the Middle East and North Africa, 61% in East and South Africa and East and Pacific-Asia, 46% in Latin America and Caribbean, to the 28% of West and Central Africa. In 2000, 2010, and 2018, most deaths in the age range 0-19 have affected children between 0 and 4, even though the percentage has decreased by 24% between 2000 and 2018.

The primary prevention of new HIV infections among women of childbearing age, together with early access to prenatal treatment and to the HIV test, are the key to solve the problem. New technologies and treatments have shown promising results, but globally children are less covered than adults by the life-saving antiretroviral treatment (54% against 62%), even though paediatric access to ART has almost tripled since 2010.

Like other complex challenges, the global HIV epidemic appears different depending on the perspectives and the contexts taken into consideration. The success of the last years in preventing mother-to-child transmission is undeniable, but this positive change proceeds still too slowly to actually reduce the risk and vulnerability of this age range on the whole. Children are disproportionally affected by HIV, even though they do not fall into the categories usually perceived by the common collective imagination. The diagnosis, test, and treatment of HIV in paediatric age must be broadened so that it becomes progressively compliant with the services reserved for adults, and these measures must be made available in those places where the most affected children live. At the same time, it is necessary to develop and maintain a greater number of drugs, specifically suitable for children, at an affordable price. But the efforts of research are not enough to reach this aim, political will and investments are needed. Governments, non-governmental organizations, health experts, and civil society must support significantly the development of fixed-dose combination drugs suitable for children, to guarantee a simple and efficient treatment that can be accessed in every part of the world; to safeguard the right to life, without HIV, to every infant.

Our latest D-Story
How and why Eurasianism works well in Italy
August 18, 2022 | Politics
Glaciers’ surfaced decreased of 30% in the last sixty years and by 2040 one of the most important is likely to disappear
August 2, 2022 | Environment
Originals