HIV/AIDS

When it comes to age, HIV/AIDS does not discriminate. A newborn baby, a barely walking toddler, a curious and feisty five-year-old, a determined teenager - all are susceptible to the disease and the myriad of ways it sends families and communities into cycles of extreme poverty, grief and despair.

From contracting AIDS themselves to losing parents and family members to the disease, children are much like sitting ducks in a raging storm; emerging from childhood unscathed from AIDS in the developing world is becoming more and more unlikely. In 2005, an astounding 2.3 million children were living with HIV globally. And for most of these children, whose situations are made worse by extreme poverty, contracting HIV is almost always an imminent death sentence.

Although it is commonly assumed that HIV/AIDS is an adult disease, children are infected through mother-to-child transmission, injections using unclean needles or contact with unclean medical equipment and through sexual abuse. During 2005, an estimated 700,000 children were infected with HIV, 80 percent of which occurred in sub-Saharan Africa. Because children's immune systems are weaker, a condition only exacerbated by malnutrition and poverty, HIV advances in children much more quickly.

Children who are not infected by AIDS directly often watch one or both parents die from the disease. Along with the psychological trauma suffered, there are several other ways children are affected when their parents are sick with HIV/AIDS:

• In a role-reversal, children are forced to become the caregivers to sick parents;
• No longer able to financially support their families, sick parents must rely on children to carry the financial burden; children are pulled out of school, can become exploited labor, or, in desperate situations, sold into slavery or prostitution;
• Children are forced to become the head of the family and care for younger siblings;
• Children are denied a childhood as the parents' responsibilities become their own;
• Children are orphaned and are left with extended families, in orphanages or on the streets;
• Children may be stigmatized and discriminated against because of HIV/AIDS.

Extreme poverty can be both a cause and an effect of HIV/AIDS. Children who are poor are more vulnerable and susceptible to the disease, do not receive adequate information on how to prevent the disease and do not have access to the medical treatment and care that is provided in the developed world.

World AIDS Day -Will you help to keep the promise?

By Cynthia Eugster

"You must be the change you wish to see in the world." Gandhi

World AIDS Day is on December 1st, will you help to keep the world promise of stopping AIDS by 2015? In 1988 the World Health Organization established World AIDS Day to give global attention to the horrific HIV/AIDS epidemic. In recognition for this day, governments, communities, faith organizations, AIDS programs, and individuals have a chance to demonstrate how important the war on HIV/AIDS can be worldwide and to gain attention to the problem. In 2000, leaders pledged their support to reduce extreme poverty during the United Nations Millennium Summit. Millennium Development Goals were established creating a timeline for the world to reduce extreme poverty by 2015. At the summit each country agreed to amplify their aid to developing countries to 0.7 percent of their national income to help achieve these goals. One of the eight goals is to combat HIV/AIDS, malaria, and other diseases. A theme for World AIDS Day is "Stop AIDS: Keep the Promise," and in addition to that theme is "leadership" for 2007. Now is the time to spread the word and become an active member in helping to reduce the traumatic effects of HIV/AIDS. Join us as we participate in World AIDS Day.

HIV/AIDS is an epidemic sweeping the globe that kills millions of children each year. In 2006, more than half a million children became infected with HIV. (UNAIDS Epidemic 2006) Compared to 2004, the number continues to increase rather than decrease. Many of the children that contract this infection obtain it by mother-to-child transmission (MTCT). This can include pregnancy, birth, and breast feeding. (Avert, Children) Infants infected with HIV commonly show clinical symptoms within their first year of existence and one third of infected infants will die by one year of age and half by two years of age. (WHO) As of 2006, two million children are living with HIV. Nine out of ten children living with AIDS come from Sub-Saharan Africa. (UNAIDS Epidemic 2006)

HIV is the human immunodeficiency virus and is a retrovirus that infects cells of the human immune system, destroying or impairing their function. In the early stages of the infection, symptoms may not emerge. As time goes on and the infection advances, the immune system begins to break down and becomes frail or weak. When the immune system starts deteriorating, the person becomes more vulnerable to other infections or viruses. The most progressive stage of HIV infection is acquired immunodeficiency syndrome (AIDS). (WHO)

A number of steps need to be taken in order to reduce these unacceptable encounters of infections through mother-to-child transmission. These include:

• Providing support and care for women and children living with HIV.
• Providing education on HIV/Aids to girls and women to help raise awareness and thereby prevent infection.
• Preventing unwanted pregnancies with women HIV infected.
• Strengthening health centers in order to prevent MTCT, this includes the use of antiretroviral drugs, and that they be safely and effectively implemented.

In many developing countries resources for preventing or helping to reduce the effects of HIV on children that have transmitted the infection by mother-to-child are limited. Everyday 1800 more children become infected with HIV and a large portion of them are newborns. (UNAIDS) Antiretroviral drugs (ART) must be provided to the HIV infected pregnant woman and the newborn in order to reduce the risk of mother-to-child HIV transmission.

HIV mothers should also use ART for their own health. (UNAIDS) In previous case studies in Uganda, it shows that a single dose of nevirapine at labor and a single dose to the newborn within 72 hours of birth can reduce the risk of HIV transmission down to 13%. This is almost two-fold lower than a short course of zidovudine started during labor, according to the World Health Organization (WHO). WHO and its partner UN agencies support the use of nevirapine and believe that it should be included in the minimum standard package of care for HIV mothers and children. In current years, resource-limited areas have focused their preparation of single-does intrapartum and neonatal nevirapine to prevent MTCT, thus cutting the risk of HIV transmission by forty plus percent. (UNAIDS)

In the South American country of Guyana, just east of Venezuela, a young mother in her mid-twenties is going in for an antenatal visit for her second pregnancy. Brenda has undergone HIV pre-test counseling and has taken the HIV test. She discovers on her next visit the results of the test, its HIV positive. Health workers reassure her that she can live a healthy life with HIV. After she tells her family of the results, they provide the support she needs in order to go through with the Prevention of Mother to Child Transmission (PMTCT) program.

The PMTCT program beginning in 2003 Brenda is participating in is funded by the USAID. This program is helping mothers with the support and care they need. They provide counseling, testing services, and drugs, if testing positive, to prevent MTCT. The goal of this particular program is to reduce MTCT rates by 50% by 2008 and also to assist the local government in strengthening the efforts they have made thus far.

A couple hours before the birth of Brenda's baby, she was given antiretroviral prophylaxis drugs and the baby was given nevirapine. The baby is now HIV negative. Brenda is one of 2,783 women whom receive PMTCT services in 2003. Brenda has received further education and counseling on infant feeding, safe sex practices, etc. She has also joined a support group and became an educator at the Network of People Living with HIV/AIDS.

One child is saved from the effects of HIV and possibly death from AIDS because a woman had the opportunity to receive the care and support needed in coping with HIV. PMTCT programs are essential in overcoming the traumatic encounters of mother-to-child transmission. We encourage you to become active in fighting HIV/AIDS. Together we can save the lives of millions of children from being infected with the HIV virus. Join us on World AIDS Day as we take action and keep the promise!

Sources:
http://www.unaids.org/en/Policies/HIV_Prevention/PMTCT.asp
http://www.fhi.org/en/HIVAIDS/pub/fact/reducingmtct.htm
http://www.avert.org/motherchild.htm
http://www.unfpa.org/hiv/transmission.htm
http://www.who.int/reproductive-health/publications/archive/nevirapine.htm
http://www.who.int/reproductive-health/publications/new_data_prevention_mtct_hiv/
http://www.theglobalfund.org/en/about/record/
http://www.usaid.gov/stories/guyana/ss_guyana_hiv.html

HIV/AIDS Article

by Megumi Mori

HIV, human immunodeficiency virus, has now spread to every country in the world and has infected more than 40 million people worldwide as of the end of 2003. More than 1.1 million people in the United States have been infected with HIV. The scourge of HIV has been particularly devastating in Sub-Saharan Africa. The proportion of adult women among those infected with HIV is increasing.

Population, Poverty and HIV/AIDS

The AIDS pandemic has gained momentum during the past quarter century, expanding to all regions of the world. AIDS have effect both the rich and the poor people. However, higher amount of poor people tend to be HIV-positive.

Poverty and HIV/AIDS are interrelated. Poverty is leading to behaviors that expose people to the risk of HIV infection, and poverty exacerbates the impact of HIV/AIDS.

Sub-Saharan Africa has so far borne the brunt of the AIDS devastation, and the region continues to experience high rates of infection. Countries in Eastern Europe and Asia have the fastest-growing rates of HIV infection in the world. The populous countries of Chine, India and Indonesia are of particular concern. Globally, the highest HIV prevalence rates are found I poor countries, but within regions such as Africa, it is not necessarily the poorest countries that have the highest prevalence rates. Nevertheless, poverty increases vulnerability to HIV/AIDS and aggravates the devastation of the epidemic. The poorness often lacks the knowledge and awareness that would enable them to protect themselves from the virus, and once infected, they are less able to give life-prolonging treatment. By the end of 2004, there were an estimated 39 million people living with HIV/AIDS, an increase from 37 million in 2002. Among the people infected with HIV, 25million lived in sub-Saharan Africa, 7.1 million in South and South-eastern Asia, and over 2million in Latin America and the Caribbean. Thus, 64 percent of HIV-infected people are located in the countries of sub Saharan Africa, while this region was home to only 11 percent of the world's population. Within Africa, the most affected populations are found in Eastern and Southern Africa. Rates of infection are aril on the rise in many countrie4s in sub-Saharan Africa, such as Gabon, Guinea, Liberia, Madagascar and Swaziland. Abrupt increases in HIV infections have been observed in China, Indonesia and Viet Nam. Countries of Eastern Europe and Central Asia have fast- expanding epidemics fuelled by injecting drug use.

Most of the AIDS-affected countries have young populations. The average proportion of children under 15 in the heavily affected countries is significantly higher than that of the less developed regions as a whole, while the proportions of adults and older person are lower. The most immediate effect of the epidemic has been to increase mortality. Countries that are highly affected by the HIV/AIDS epidemic have higher mortality than the less developed countries on the whole. For 2000 and 2005, the average life expectancy at birth in the AIDS-affected countries is 48 years, for the less developed regions, 15 years lower than the average, and 2 years lower than the average for the least developed countries.

HIV/AIDS Factors

Biological factors

• Sexual transmission: Sexual transmission explains most HIV infections worldwide even though the risk of transmission per sex act is estimated at between 1 in 100 and 1 in 1,000. This risk increases considerably for those who have untreated sexually transmitted infections, especially where there are open sores or ulcers.
• Exposure to blood: Direct exposure to infected blood is the most efficient route of transmission. Injecting drug use is the most common means of blood- borne HIV transmission, accounting for approximately 10 percent of all infections worldwide.
• Mother-to child transmission: In the absence of any preventive intervention, a baby born to an HIV-infected breastfeeding mother faces a roughly 20-45 percent chance of contracting HIV. The risk of transmission is greater when the mother's viral load is elevated.

Social or other factors

HIV transmission is profoundly influenced by the surrounding social, economic and political environment, including factors such as poverty, oppression, discrimination and illiteracy.

• Poverty: In both high-income and developing countries, AIDS has often struck society's wealthiest and most influential, understanding the universal nature of the threat posed by the epidemic. In general, however, the impacts of AIDS have disproportionately affected those who have the fewest economic and social resources. The epidemic reinforces these conditions by undermining food and economic securit7y in the hardest-hit countries. AIDS deepens poverty and increases the number of poor at risk of infection, because those with the fewest resources have the least access to health-care services or health-related information.
• Stigma and discrimination: The groups at highest risk of HIV infection are typically those who suffer from officially and unofficially sanctioned forms of discrimination. Sex work and injecting drug use are often illegal and elicit strong disfavor in many countries. Such forms of stigma are reinforced by the stigma associated with HIV itself.
• Gender inequities: Many women in the hardest-hit countries face heavy economic, legal, cultural and social disadvantages which increase their vulnerability to HIV infection and to the epidemic's impact. In many countries, girls have limited educational opportunities. In some countries, women have few rights with respect to property ownership or secure tenure or to inheriting wealth, and many women either experience or are at high risk of, sexual assault or other forms of violence. Divorce or the death of a husband can lead to destitution, sometimes forcing women to turn to sex for survival.
• Mobility: Mobility significantly increases HIV-related risk. Often, migrant workers move from low-prevalence rural regions to urban centers, when HIV prevalence is much higher and risk behaviors are more frequent.
• Conflict: In 2003, more than 72 countries were identified as unstable, and as a result of various conflicts, there are more than 42 million refugees and internally displaced people worldwide. Populations fleeing complex emergencies such as armed conflict typically face destitution and food shortages. These conflicts can also create conditions that increase the risk of contracting infections such as HIV.
• Countries in transition: Where countries undergo profound social, economic and political changes, HIV-related risk behaviors often increase. In the countries of the former Union of Soviet Socialist Republics, the age at which sex is initiated has fallen and drug use has increased.
• Incarceration: At any given time, approximately 10 million people are imprisoned all over the world. Prisons are often breeding grounds for infectious diseases such as HIV, tuberculosis and hepatitis. Prison populations typically come form the most marginalized segments of society, which are already at high risk of HIV infection.

In brief, the risk of HIV infection and the impact of the epidemic on those who are infected and affected can differ profoundly depending on personal and social circumstances. Therefore, responses to the epidemic need to take account of the important contextual circumstances that may increase vulnerability.

Prevention

The steady growth of HIV prevalence throughout the world stems not form the deficiencies of available prevention strategies and tools but rather from the failure to use them. At present, there are more infections every year than AIDS-related deaths. The trends in increasing infections pose a major threat to the global response to AIDS.

Essential Policy Actions for HIV prevention

Taken from http://www.unaids.org/en/Policies/HIV_Prevention/

• 1, Ensure that human rights are promoted, protected and respected and that measures are taken to eliminate discrimination and combat stigma.
• 2, Build and maintain leadership from all sections of society, including governments, affected communities, nongovernmental organizations, faith-based organizations, the education sector, media, the private sector and trade unions.
• 3, Involve people living with HIV, in the design, implementation and evaluation of prevention strategies, addressing the distinct prevention needs.
• 4, Address cultural norms and beliefs, recognizing both the key role they may play in supporting prevention efforts and the potential they have top fuel HIV transmission.
• 5, Promote gender equality and address gender norms and relations to reduce the vulnerability of women and girls, involving men and boys in this effort.
• 6, Promote widespread knowledge and awareness of how HIV is transmitted and how infection can be averted.
• 7, Promote the links between HIV prevention and sexual and reproductive health.
• 8, Support the mobilization of community-based responses throughout the continuum of prevention, care and treatment.
• 9, Promote programs targeted at HIV prevention needs of key affected groups and populations.
• 10, Mobilizing and strengthening financial, and human and institutional capacity across all sectors, particularity in health and education.
• 11, Review and reform legal frameworks to remove barriers to effective, evidence based HIV prevention, combat stigma and discrimination and protect the rights of people living with HIV or vulnerable or at risk to HIV.
• 12, Ensure that sufficient investments are made in the research and development of, and advocacy for, new prevention technologies.

Further Resources: United Nations, "Development and HIV/AIDS with Particular Emphasis on Poverty: The Concise Report."

Related Organizations and Campaigns

Unite For Children Unite Against AIDS by UNICEF

This project is conducted to notify the world to the fact that children are missing from the global AIDS agenda. It provides a place for urgent and sustained programs, advocacy and fundraising to restrict the impact of HIV/AIDS on children and combat the spread of the disease.
URL: http://www.uniteforchildren.org/index.html

Keep A Child Alive by Leigh Blake

Keep A Child Alive is a campaign that offers people the opportunity to provide lifesaving antiretroviral (ARV) medicine and support services directly to children and families with HIV/AIDS in some of the world's poorest countries. A Child Alive was founded by Leigh Blake, a leading AIDS educator, fundraiser, and activist who also co-founded The Red Hot Organization and Artists Against AIDS Worldwide. Ms. Blake has produced an extraordinary array of music, films, and media events.
URL: http://www.keepachildalive.org/index.php

HERO: A UNA-USA Campaign by USAID

A UNA-CAN Campaign, in a partnership with the United States Agency for International Development, is an awareness building and fundraising initiative dedicated to providing comprehensive, school-based support to orphans and vulnerable children living in HIV/AIDS-affected communities in Africa.
URL: http://www.heroaction.org/site/c.gpIPKZOAJoG/b.2030943/k.BDE5/Home.htm