Dr Ravinder K Gupta, Dr Ariba Afeeh
An Urgent Call for Action against Childhood AIDS continues to pose a significant global health challenge, affecting millions of children across the globe. Despite notable advancements in treatment and prevention that have alleviated the impact of HIV/AIDS among adults, children, particularly in resource-limited environments, remain disproportionately affected.
As reported by the Joint United Nations Programme on HIV/AIDS (UNAIDS), around 1.7 million children under 15 were living with HIV in 2023, predominantly in sub-Saharan Africa, where healthcare access is often inadequate. A significant number of these children contract the virus through vertical transmission from their mothers during pregnancy, childbirth, or breastfeeding. Without timely medical intervention, nearly 40% of infants born to HIV-positive mothers may become infected; however, with appropriate antiretroviral therapy (ART) during pregnancy and delivery, this transmission rate can be reduced to below 5%. The effects on children with HIV/AIDS has profound physical, emotional, and social repercussions for children.
Untreated HIV compromises the immune system, making children susceptible to severe infections such as pneumonia and tuberculosis, as well as malnutrition. Additionally, the stigma associated with the disease can lead to discrimination, social isolation, and mental health challenges. Education is also adversely affected, as many children living with HIV or those orphaned by the disease encounter obstacles to schooling due to poverty, stigma, or the need to care for ill family members.
Progress and Ongoing Challenges
In recent decades, substantial strides have been made in the prevention and treatment of childhood AIDS. The development of pediatric formulations of ART has significantly enhanced the quality of life for many children living with HIV, transforming the condition from a fatal diagnosis into a manageable health issue.
Prevention is the cornerstone of eliminating childhood AIDS, and it requires a multifaceted approach to be truly effective. At the heart of prevention efforts are strategies to eliminate mother-to-child transmission (EMTCT) of HIV. Ensuring that all pregnant women have access to HIV testing and antiretroviral therapy (ART) is crucial, as it allows them to receive the necessary treatment and prevent passing the virus on to their children during pregnancy, childbirth, or breastfeeding. Additionally, empowering women to make informed choices about their reproductive health through access to contraceptives is a key component, as it enables them to plan their families and avoid unintended pregnancies that could lead to vertical HIV transmission. Alongside these medical interventions, education and awareness campaigns play a vital role in combating the stigma surrounding HIV/AIDS. By promoting early testing and normalizing conversations about the virus, these efforts can encourage more people, including expectant mothers, to seek testing and care, ultimately breaking the cycle of transmission.
However, addressing childhood AIDS requires a collective effort that extends far beyond the medical realm. Policymakers must prioritize funding for comprehensive HIV prevention and treatment programs, particularly in resource-poor settings where access to healthcare may be limited. Healthcare workers, in turn, need specialized training to effectively diagnose and manage pediatric HIV, ensuring that children living with the virus receive the best possible care. At the community level, dismantling the social stigma that prevents many from seeking testing and treatment is crucial, as families affected by HIV/AIDS often face marginalization and isolation. International organizations and donor countries also have a crucial role to play in sustaining their support for HIV/AIDS programs, recognizing that ending childhood AIDS is not just a matter of public health, but a moral imperative to ensure that every child, regardless of their birthplace, has the opportunity to grow up healthy and fulfilled.
The vision of an AIDS-free generation is within reach, but it will require unwavering commitment and a coordinated global effort. With continued investment in research, expanded access to treatment, and a steadfast focus on prevention, we can create a world where no child is born with HIV and those living with the virus can lead full and productive lives. It is our collective responsibility to act, because every child deserves a chance at life, free from the shadow of AIDS.
Childhood AIDS in Jammu and Kashmir: Confronting a Hidden Crisis Jammu and Kashmir (J&K), renowned for its stunning landscapes and resilient populace, is not exempt from the global challenges posed by HIV/AIDS. Although the prevalence of HIV in J&K is lower than in many other Indian states, the region encounters distinct challenges that necessitate immediate attention, particularly regarding children who are living with or affected by HIV/AIDS.
As reported by the National AIDS Control Organisation (NACO), J&K has a relatively low HIV prevalence, representing less than one percent of the national total. However, a low prevalence does not equate to an absence of risk. In recent years, isolated cases of pediatric HIV have emerged, predominantly attributed to mother-to-child transmission (MTCT). The region’s mountainous geography, dispersed population, and inadequate healthcare infrastructure in certain areas hinder the provision of consistent HIV testing, prevention, and treatment services. Furthermore, the stigma surrounding HIV/AIDS in J&K often deters families from seeking timely diagnosis and care for their children.
Factors Contributing to Pediatric HIV in J&K Several elements heighten the risk of childhood AIDS in J&K:
Mother-to-Child Transmission (MTCT): Insufficient awareness and limited access to antenatal care (ANC) and antiretroviral therapy (ART) in rural and remote regions elevate the risk of MTCT.
Delayed Diagnosis: Numerous children born to HIV-positive mothers are not tested promptly, leading to a delay in the commencement of treatment.
Stigma and Discrimination: Cultural stigma associated with HIV/AIDS discourages families from utilizing healthcare services, further marginalizing children affected by the disease.
Migration and Conflict: Frequent migration due to economic hardships or conflict disrupts the continuity of care, particularly for families residing in border regions.
To address childhood AIDS in J&K, a comprehensive approach is crucial.
Enhancing Prevention Programs: – Expanding the outreach of Prevention of Mother-to-Child Transmission (PMTCT) programs and ensuring all pregnant women in the region are tested for HIV and receive appropriate care.
Promoting institutional deliveries in Government healthcare facilities equipped to handle HIV-positive pregnancies.
Improving Pediatric Care: Establishing dedicated pediatric ART centres in underserved areas. Training healthcare providers in diagnosing and managing HIV in children, with a focus on early infant diagnosis (EID).
Enhancing Community Awareness: Conducting community-based awareness campaigns to reduce stigma and encourage voluntary testing. Collaborating with local influencers, such as religious leaders and social workers, to promote acceptance and support for affected families.
Policy and Infrastructure Development: Strengthening healthcare infrastructure in remote areas to improve access to diagnostic and treatment facilities. Ensuring the availability of pediatric ART and nutritional support for children living with HIV.
Support for Orphaned and Vulnerable Children: Establishing social support systems, including educational scholarships and psychosocial counselling, for children orphaned by AIDS.
J&K has a strong tradition of community solidarity, which can be a powerful tool in addressing childhood AIDS. Local NGOs, healthcare workers, and Government agencies must work collaboratively to bridge gaps in care and foster an environment where children and families affected by HIV feel supported.
One such initiative is the integration of HIV-related services into the region’s Ayushman Bharat health scheme, ensuring financial protection and access to essential services for vulnerable families. Programs like these need to be scaled up and localized to meet the unique needs of J&K’s population.
A Future Without AIDS in J&K Jammu and Kashmir stand at a crossroads in its fight against HIV/AIDS. By investing in prevention, treatment, and community education, the region can ensure that no child is left behind. Addressing childhood AIDS is not just a public health priority; it is a moral and social responsibility. In a land known as “Paradise on Earth” every child deserves a chance to grow up healthy and unburdened by the challenges of HIV/AIDS. Through collective effort and unwavering commitment, J&K can pave the way for a brighter, AIDS-free future.
December 1 is World AIDS Day, a time to remember and honor the more than 32 million people who have died worldwide from AIDS-related illness and renew our commitment to ending the HIV epidemic. This year’s theme, “Collective Action: Sustain and Accelerate HIV Progress,” challenges us to work collaboratively and in community with each other to maintain and build on our progress.
As the Slogan on this occasion “Take the rights path” depicts, the world can end AIDS – if everyone’s rights are protected. With human rights at the centre, with communities in the lead, the world can end AIDS as a public health threat by 2030.
The authors are from Department of Pediatrics, Acharya Shri Chander College of Medical Sciences (ASCOMS) Jammu
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