A very large number of HIV-infected pregnant women globally do not receive treatment – in fact, in 2012, only 37% of women in low and middle-income countries received antenatal HIV testing. The suboptimal coverage of detection and treatment resulted in an estimated 260 000 children acquiring HIV in 2012, adding to the 3.3 million children under the age of 15 living with HIV, indicating that ‘the paediatric HIV epidemic is far from over’.
This is according to guest editors Linda Richter and Lynne Mofenson in the journal AIDS, the official scientific journal of the International AIDS Society, which is the most highly cited journal in the HIV and AIDS field. Hundred-and-fifty authors contributed to this special edition which includes 16 peer-reviewed articles addressing critical issues for children born into families affected by HIV.
The journal was launched here on 18 July at the Children and HIV Symposium in Melbourne, Australia.
Melbourne Declaration Ambassadors
Richard Branson
Founder of Virgin Group
Chris Beyrer
President Elect of IAS, Professor of Epidemiology, International Health, and Health, Behavior and Society Director, Center for Public Health and Human Rights
Françoise Barré-Sinousi
International Chair, AIDS 2014, President, International AIDS Society, Director, Regulation of Retroviral Infections Unit, Institut Pasteur
Edwin Cameron
Justice of the High Court, South Africa
David Cooper
Professor of Medicine, University of New South Wales and a Fellow of the Australian Academy of Science (FAA)
Mark Dybul
MD, Executive Director, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
Shaffiq Essajee
Senior Medical Advisor, Clinton Health Access Initiative, Boston, United States
Bob Geldof
Singer and Activist
Beatriz Grinsztejn
Director, STD/AIDS Clinical Research Laboratory at the Clinical Research Institute Evandro Chagas (IPEC/FIOCRUZ), Brazil
Richard Horton
Editor, The Lancet
Adeeba Kamarulzaman
Dean of Medicine, Professor of Infectious Diseases, University of Malaya
Michel Kazatchkine
UN Special Envoy for HIV/AIDS in Eastern Europe and Central Asia
The Hon. Michael Kirby
Former Justice of the High Court, Australia
Rep. Barbara Lee
Member of the U.S. House of Representatives from California’s 13th district, United States
Sharon Lewin
Co-Chair, AIDS 2014, Professor and Head, Department of Infectious Diseases, Alfred Hospital and Monash
Kenneth Mayer
Medical Research Director of Fenway Health and Co-Chair of the Fenway Institute in Boston, United States
Daisy Nakato Namakula
Executive Director, Women’s Organization Network for Human Rights Advocacy (WONETHA), Kampala, Uganda
L’Orangelis Thomas Negron
Network of Positive Youth for Latin America and the Caribbean University, Co-Head, Centre for Biomedical Research, Burnet Institute, Melbourne
Olive Shisana
Co-chair, AIDS 2016, CEO, Human Sciences Research Council, Cape Town
Michel Sidibé
Executive Director, UNAIDS
Aung San Suu Kyi
Nobel Laureate and Chairperson of the National League for Democracy in Myanmar and UNAIDS Global Advocate for Zero Discrimination
Archbishop Desmund Tutu
South Africa
Sketching the background to the edition, Prof. Richter, director of the DST-NRF Centre of Excellence, University of the Witwatersrand and distinguished research fellow at the Human Sciences Research Council of South Africa, said eight eminent researchers in their field were invited to look at 100 years of evidence and to give guidance on the long-term effect on children of nutrition, growth and development, attachment and disruption, parental ill-health, separation and death, parental mental health, violence stigma, resilience, and poverty.
“The result was an amazing accumulation of evidence in ways HIV affect children”, Richter said The immediate and short-term consequences of adult HIV on affected children are well documented but little research looked at the long-term implications of childhood hardship.
Although findings are not directly transferable across children or the contexts children live in, it was found that regardless of the type of hardship suffered by children affected by HIV and AIDS, the majority of children (60% – 80%) showed resilience in overcoming their circumstances and are unlikely to display negative outcomes in the long run. Parental family warmth and acceptance, also from caregivers, act as protection and account for an enormous part of the variation in children’s outcomes.
On the negative side, a significant minority of children suffer not one, but many traumas of which abject poverty is one. “If stresses are unrelenting and enduring they accumulate and, in the absence of support and opportunities for recovery, affected are highly likely to suffer enduring results”, Richter said.
What does this mean? As the summary by Alan Stein et al states: “These insights suggest a new strategic approach to interventions for children affected by HIV and AIDS, one that effectively combines a universal lattice of protection with intensive interventions targeted to selected children and families”.
The special edition is available on www.AIDSonline.com
Note to news editors: for interviews with Professor Linda Richter, e-mail Ina van der Linde on ivdlinde@hsrc.ac.za.