The global pediatric HIV epidemic is shifting into a new phase as children on antiretroviral therapy (ART) move into adolescence and adulthood, and face new challenges of living with HIV. UNAIDS reports that 3.4 million children aged below 15 years and 2 million adolescents aged between 10 and 19 years have HIV. Although the vast majority of children were perinatally infected, older children are combined with behaviourally infected adolescents and youth in global reporting, making it difficult to keep track of their outcomes. Perinatally HIV-infected adolescents (PHIVA) are a highly unique patient sub-population, having been infected before development of their immune systems, been subject to suboptimal ART options and formulations, and now face transition from complete dependence on adult caregivers to becoming their own caregivers. As we are unable to track long-term complications and survival of PHIVA through national and global reporting systems, local and regional cohorts are the main sources for surveillance and research among PHIVA. This global review will utilize those data to highlight the epidemiology of PHIVA infection, treatment challenges and chronic disease risks. Unless mechanisms are created to count and separate out PHIVA outcomes, we will have few opportunities to characterize the negative consequences of life-long HIV infection in order to find ways to prevent them.
An HIV Positive Caribbean Child’s Story
Latin America and The Caribbean – The Reality
The 2011 UNAIDS estimates for Latin America and the Caribbean were 60,000 HIV-infected children under 15 years of age, 3300 new pediatric infections, and 3500 deaths . The two countries with the most infected children in these regions are Brazil (20,000 infected children under 15 years of age), the largest economy in Latin America, and Haiti (13,000 infected children under 15 years of age), the poorest country in the Western hemisphere. The Reality is that these numbers have since increased. Funding for HIV/AIDS to the Caribbean has decreased and in some instances ended. Children suffer most.
Apart from the stigma and fear that children with HIV/AIDS endure in the Caribbean the lack of education about the condition coupled with the in-access to testing and treatment doesn’t help the situation.
We work with partners across the Caribbean to provide updated current education materials to children about AIDS and HIV. In appropriate forums, we encourage peer discussions with the goal of erasing the stigma associated with the condition in the region.
With the region having the one of the highest levels of adolescent sexual activity, we advocate for the distribution of condoms in High Schools and for information on Safe Sex practices to be incorporated in school curriculums.
We work directly with the Cyril Ross Nursery (a home for HIV positive children and children living with AIDS) on the Caribbean island of Trinidad.