Reaching Out to HIV/AIDS Infected Children in Remote Areas of Africa

Abstract

Although statistics have shown decreases in HIV/AIDS prevalence and incidence in South Africa due to better medicines, prevention/intervention programs and volunteer organization support; the number of people diagnosed with HIV/AIDS is the highest in the world. This study examines current prevention and intervention programs implemented in South Africa focused on children and attempts to discover the most successful of the evaluated programs and why it has been successful.

South Africa has the highest total number of people infected with HIV/AIDS (AVERT). The focus of this study is on the children of South Africa both diagnosed HIV/AIDS and uninfected. The purpose of studying both groups of children is to investigate current methods of medical and educational intervention and prevention. This is a field research study of existing literature and studies as means of identifying factors of decreasing HIV/AIDS infections among children of South Africa. Most AIDS organizations consider the definition of a child as a person fifteen years of age or younger; even though International Law considers children to be any person under the age of eighteen (Berry, 2006). Most literature concerning children with HIV/AIDS discusses children age fifteen or younger; therefore, this study will focus on this age frame as well. It should be noted however, that this miscommunication of age ranges can cause the reporting of inaccurate statistics.

Statement of the Problem

Children in South Africa are affected by the AIDS pandemic on many levels. The most common instances of child HIV/AIDS contraction is, mother-to-child transmission, medical infection and infection through sex and drugs (Berry, 2006). Over one million children have been orphaned by AIDS (AVERT). Forty percent of children under the age of five die from AIDS. Literacy rates are poorest, and unemployment is the highest among provinces with a high population of children. Children are lacking education; over one million South African children do not go to school for various reason, including, malnutrition, far distances from school, lack of resources and the general lack of parental education (AVERT). Social services have limited abilities with many of South Africa's children because many are not registered; at least half (AVERT).

HIV affects a child in the form of the child himself, family and community (Berry, 2006). Many children are forced to act as adults by becoming the wage earners to pay for the medical bills of their parents who are too sick to work because of HIV/AIDS. The community is affected by the loss of important members of society such as school teachers and mayors.

HIV Treatment, Testing and Care Methods

HIV progresses differently in children than adults (AVERT), which is why it is imperative that children have access to medical staff specifically trained in child HIV treatment. Unfortunately, "highly-affected African countries" have little to no medical care (AVERT). There are delays in providing needed tests and drugs to areas of high poverty, which are available in wealthy areas.

If infected with HIV, children can be effectively treated, and given this treatment, can have longer, healthier lives-yet they continue to die, because the treatment is not available in many countries (AVERT).

Children's medication in developing countries tends to be very expensive. Drug manufacturing companies are not as motivated to make medicines for poor countries as it is wealthier ones, because it does not pay enough (AVERT). There are not enough child appropriate antiretroviral treatments available for HIV/AIDS infected children. Not surprisingly, "HIV in children is rare in the developed world" (AVERT). The needs of developing countries include, drug treatments for children, staff specialist training and treatment and continued care treatment (2006).

HIV testing is unreliable for very young children (AVERT). "The antibodies disappear by the time the child is eighteen months old, unless they are truly infected (AVERT)". Doctors need more expensive testing methods or implement system monitoring methods (AVERT). Well-resourced areas have access to better assessment methods; a viral load test and a test which counts CD4 cells. A more specialized medical staff is needed to accurately interpret either test's results, making it impractical for areas of limited resources (AVERT).

Children with HIV are prone to "opportunistic" infection due to a weakened immune system. They are especially vulnerable to PCP, a type of pneumonia. An antibiotic, Co-trimoxazole, is "effective at preventing various opportunistic infections; it can also "delay the need for antiretroviral treatment (AVERT)". When administered to children exposed to HIV, during the ages of four to six weeks old, it can be continued indefinitely with optimal results.

Mother-to-Child Transmission

Mother-to-child transmission is almost completely avoidable and is less frequent in well developed countries (AVERT). In 2005, only nine percent of woman in resource-poor countries were offered any type of prevention services (AVERT). One seemingly simple strategy would be to provide artificial breast milk to mothers with HIV/AIDS. Unfortunately, limited resources, mobility and other issues prevent this from happening (AVERT). Providing antiretroviral treatments to the expectant mother could reduce the chance of the child contracting AIDS from the mother. C-section is another measure of precaution. However, the most effective strategy of prevention is to help woman avoid contracting HIV or getting pregnant with unwanted child with sexual education.

Avoiding Infection Through Sex and Drug Use with Education

Several AIDS organizations have been making progress especially in terms of education as means of HIV/AIDS prevention. In a 2005 press release, the Joint United Nations Programme on HIV/AIDS (UNAIDS) reported their research on AIDS prevalence and incidence. UNAIDS report;

Found preliminary indications of declining trends in HIV prevalence and incidence in Zimbabwe over the last five years (2005).

More specifically, this report showed that the occurrence of pregnant woman with AIDS dropped from 24.6 percent to 21.3 percent from 2002 to 2004. Possible explanation for the decline involved behavioral changes such as, safer sex practices and a decrease in sexual partners. Similarly, the Human Science Research Council (HSRC) released the results of a study in 2005 which linked the changes in South Africans' behaviors and a reduction in HIV prevalence. More importantly, these behavioral changes were a result of HIV/AIDS education and awareness (2005). This suggests that the "strong prevention programs implemented by a wide range of stakeholders" such as the South African Government, Nongovernmental organizations (NGOs) and Faith-based Organizations (FBOs) are having an impact on the South African AIDS pandemic. The key factor in developing and implementing programs aimed at combating AIDS in South Africa, is sustaining potential results. As AIDS prevalence and incidence decrease educational programs must continue to teach and promote safe sex, reducing the number of sexual partners, abstinence and condom use. With children, it is essential to begin teaching these elements early in life, which is why it is so crucial that the children can get to school and medical centers.

Children as well as adults have problems getting to the medical centers and clinics; volunteers, doctors and various health care workers have problems getting to patients in remote areas of Africa. There is a lack of "conventional maintenance systems in Africa" (Riders, 2006). There is no reliable transportation, much needed medicines and services can't get to those in need. Riders.org has made real effort in addressing this issue, as stated in their website;

The tried, tested proven transport systems developed by Riders have already saved thousands of lives and have the potential to make a real difference throughout Africa (2006).

The Riders organization realizes the importance of reaching those in need, especially non-registered South Africans with the inability to get the help they need. This study will investigate further into the practice and the growth potential of Riders.

Avoiding Medical Transmission

HIV/AIDS transmission through medical settings is common in South Africa (AVERT) because of infected blood products (used in blood transfusions), non-sterile needles and medical equipment. This problem has been almost eliminated in wealthier, more developed countries.

Research Questions

1. What is the most high-risk area for child HIV/AIDS infection?
2. What organizations have shown the most progress in the prevention and intervention of HIV/AIDS involving children in Africa?
3. What areas of intervention and prevention of HIV/AIDS needs improvement?
4. Are there programs that can be used as models or be extended on in order to decrease the prevalence and incidence of HIV/AIDS?

Significance of the Study

This study will help determine the factors which are decreasing HIV/AIDS prevalence as well as what needs to be improved. Result-based practices will give insight into the areas demonstrating effect strategies of reducing HIV/AIDS prevalence and incidence. This study focuses primarily on South African children and their critical needs. As this study will demonstrate, medicines and medical practice are primarily focused on the adult South African, age fifteen and older; this leaves a gap, which the researcher hopes to fill with information pertaining to potential effective strategies.

Research Design and Methodology

Research will encompass existing literature pertaining to prevention and intervention strategies for combating HIV/AIDS in children of Africa. Articles, scientific journals, studies and AIDS organization briefs will be used as study components. Factors of HIV/AIDS prevention methods which will be investigated include; preventing mother-to-child transmission, avoiding medical transmission, avoiding infection through sex and drug use with education and HIV treatment, testing and care methods.

Current prevention and intervention methods will be compared for their effectiveness. Leading AIDS relief organizations such as the World Health Organization (WHO), AVERTing HIV and AIDS (AVERT), UNAIDS, and, Shared Inc. will be used as valuable sources for recent statistics and news briefs relative to children in Africa, living with HIV/AIDS.

References

AVERT. (n.d). HIV/AIDS in Children in South Africa. Retrieved on November 13, 2006 from http://www.avert.org/children.htm

Berry, Steve. (2006). Children, HIV and AIDS Retreived on November 11, 2006 from: http://www.avert.org/children.htm

SHARED, Inc. (n.d). Determine the Future of Southern Africa: A Portfolio of Projects from Lesotho Retrieved October 12, 2006 http://www.Healthshcres.org/about/projects/index/shtml

World Health Organization, (2004). Woman and AIDS: Have you Heard Us Today? Retrieved November 08, 2006 from: http://www.who.int

World Health Organization (2006). Core Health Indicators. WHO Statistical Information System (WHOSIS).Retrieved November 08, 2006 from:http://www.who.int/csr/outbreaknetwork/newthreat/en/index.htm

World Health Organization, (2006). Epidemic and Pandemic Alert and Response (EPR).

Retrieved November 08, 2006 from:http://www.who.int/hiv/mediacentre/news60/en/index.html

World Health Organization, (2006). HIV/AIDS and HIV/AIDS Country Information.

Retrieved November 08, 2006 from:http://www.who.int/hiv/en/

World Health Organization, (2006). Important Progress Seen in Tackling AIDS, but Epidemic Continues to Outpace Response, Says New Comprehensive AIDS Update. Retrieved November 08, 2006 from:http://www.who.int