Ending Pediatric AIDS and Achieving a Generation Born HIV-Free

Abstract

In the 30 years of the AIDS pandemic, the devastating effects of HIV on infants and young children have often been overlooked and neglected. However, the ability to prevent mother-to-child transmission of HIV (PMTCT), or vertical transmission, has been one of the most significant prevention success stories in the global AIDS response. New HIV infections in children have been virtually eliminated in high-income countries and programmatic efforts have shifted to low-income and middle-income countries, particularly in sub-Saharan Africa, home to the vast majority of pediatric AIDS cases.Over the past decade, the dramatic scale-up of PMTCT programs has saved millions of lives and has provided a foundation for HIV prevention and care and treatment programs that are integrated within maternal and child health services. Although some countries in sub-Saharan Africa are now approaching universal PMTCT coverage, global access to PMTCT for HIV-positive pregnant women remains at nearly 50%. Recently, a new global plan has focused efforts and resources to keep HIV-positive mothers healthy and to virtually eliminate new pediatric infections by 2015.What programmatic and technical innovations will be necessary to overcome current service gaps and implementation barriers? How can countries continue the current momentum with sustainable locally-led programs that address the epidemic in women and children? And how can the vital perspectives of communities and people living with HIV help drive these efforts? Successfully addressing these and other issues will be key to ending HIV infections in children and creating an AIDS-free generation within the next decade.

Playing the Catch-Up Game: Accelerating the Scale-Up of Prevention of Mother-To-Child Transmission of HIV (PMTCT) Services to Eliminate New Pediatric HIV Infection in Nigeria

“…[20] Uptake of services provided at facilities can be significantly improved through dedicated demand creation activities in communities. [21] The Government of Nigeria has set forth demand creation strategies [8] which were informed by locally generated evidence. It is expected that these will complement increased facility coverage to achieve a wider population coverage and uptake of services.…”

“…Encouraging, however, is the fact that many of these barriers are manageable. Dedicated and committed leadership can marshal resources and galvanize action from various stakeholders in order to address the barriers and move forward [21]. …”

Factors associated with HIV testing and receiving results during antenatal care in Tanzania

“…The third prong constitutes HIV testing and counseling, antiretroviral therapy for preventing mother-to-child transmission and infant feeding, counseling and support. Though there is a wide coverage of care treatment centers to provide PMTCT the unmet ART need remains at 48% (Lyons, Mushavi et al 2012).…”

Prevention of mother-to-child HIV transmission

“…Finally, we should not lose this unique opportunity to build on the PMTCT platform and infrastructure to address other health threats, and maternal and child mortality [29][30][31][32]. As this series of papers has demonstrated, true elimination of new pediatric HIV infections will require fundamental changes in health systems for women and children.…”