Paediatric HIV and elimination of mother-to-child transmission of HIV in the ASEAN region: a call to action

Abstract Recent achievements in scaling up paediatric antiretroviral therapy (ART) have changed the life of children living with HIV, who now stay healthy and live longer lives. However, as it becomes more of a chronic infection, a range of new problems have begun to arise. These include the disclosure of HIV serostatus to children, adherence to ART, long-term toxicities of antiretroviral drugs and their sexual and reproductive health, which are posing significant challenges to the existing health systems caring for children with HIV with limited resources, experiences and capacities. While intensified efforts and actions to improve care and treatment for these children are needed, it is crucial to accelerate the prevention of mother-to-child transmission (PMTCT) of HIV, which is the main cause of paediatric HIV in the ASEAN region so as to eliminate the fundamental cause of the problem. This report argues that given over 70% of women have access to at least one antenatal care visit in the region and acceptance of HIV testing after receiving counselling on PMTCT could be as high as 90%, there is an opportunity to strengthen PMTCT services and eventually eliminate new paediatric HIV infections in the ASEAN countries.

[1]  W. Andiman,et al.  Update on successes and challenges regarding mother-to-child transmission of HIV , 2009, Current opinion in pediatrics.

[2]  Organización Mundial de la Salud,et al.  Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report 2009 , 2009 .

[3]  R. Horton,et al.  Putting prevention at the forefront of HIV/AIDS , 2008, The Lancet.

[4]  F. Bajunirwe,et al.  Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal , 2008, AIDS care.

[5]  Nitika Pant Pai,et al.  Impact of Round-the-Clock, Rapid Oral Fluid HIV Testing of Women in Labor in Rural India , 2008, PLoS medicine.

[6]  Akihiko Saitoh,et al.  Clinical Outcomes After an Unstructured Treatment Interruption in Children and Adolescents With Perinatally Acquired HIV Infection , 2008, Pediatrics.

[7]  L. Swartz,et al.  Paediatric HIV/AIDS disclosure: towards a developmental and process-oriented approach , 2007, AIDS care.

[8]  J. Simoni,et al.  Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management , 2007, Pediatrics.

[9]  S. Marhefka,et al.  Disclosure of an HIV Diagnosis to Children: History, Current Research, and Future Directions , 2007, Journal of developmental and behavioral pediatrics : JDBP.

[10]  K. Kanal,et al.  Influence of the involvement of partners in the mother class with voluntary confidential counselling and testing acceptance for Prevention of Mother to Child Transmission of HIV Programme (PMTCT Programme) in Cambodia , 2007, AIDS care.

[11]  A. Nolan,et al.  Seizing the Big Missed Opportunity: Linking HIV and Maternity Care Services in Sub-Saharan Africa , 2007, Reproductive health matters.

[12]  T. Children,et al.  Guidance on global scale-up of the prevention of mother to child transmission of HIV: towards universal access for women, infants and young children and eliminating HIV and AIDS among children , 2007 .

[13]  P. Delamora,et al.  Caring for adolescents with HIV , 2006, Current HIV/AIDS reports.

[14]  C. Giaquinto,et al.  Older Children and Adolescents Surviving With Vertically Acquired HIV Infection , 2002, Journal of acquired immune deficiency syndromes.