During this time, HIV-infection has claimed about 40 million human lives - about 7-8 thousand people die every day, more than 2 million every day. In some regions of the world, for example in South Africa, HIV is a threat to the demographic situation for whole countries. About 15 million children worldwide are orphans due to HIV infection.
Russia belongs to countries with an average prevalence of HIV infection. Nevertheless, more than 100,000 HIV-positive people have been officially registered in the country, and the actual prevalence of infection, according to expert estimates, is 3-5 times higher. As of September 1, 2010, there were 561 cases of HIV infection in children under 14 years old, 348 of them were infected from their mothers. During the registration of HIV in Russia, 36 children died.
The main lesson learned during the years of the HIV epidemic, UN experts believe that we can prevent new infections and improve the quality of care and treatment for people living with HIV. Both these areas of action - prevention and treatment - fully apply to children.
What changed?
It's amazing how fast the global medical community mobilized to address the problem of HIV infection. A year after the first description of the disease, its causative agent - the human immunodeficiency virus - was discovered. After 4 years, laboratory tests for early diagnosis of HIV infection and testing of donor blood appeared. At the same time, a mass of preventive programs began in the world. And only 15 years later, in 1996, modern HIV treatment appeared, which significantly increased the duration and quality of life of HIV-positive people and radically changed the attitude of society towards the problem.
The definition of the "plague of the 20th century" has gone down in history. Currently, HIV is seen by doctors as a chronic disease requiring lifelong maintenance therapy. That is, from a medical point of view, HIV infection has become one of the chronic diseases such as diabetes mellitus or hypertension. European experts declare that with the quality of HIV treatment, the life expectancy of HIV-infected people should soon equal that of the general population.
Representatives of the church, who previously viewed HIV infection as a "punishment for sins", have been calling it "a test that a person needs to pass worthily" for many years, and actively participate in programs to help HIV-positive people. Now HIV infection is not called a "disease of drug addicts, prostitutes and gays", realizing that even a single unprotected sex can lead anyone to become infected with HIV.
How to prevent infection of the child?
The main way of transmission of HIV infection to children is from mother to child during pregnancy or childbirth or with breast milk. Previously, the risk of such infection was quite large, 20-40%. Children with HIV were born almost in every infected mother. But congenital HIV infection is unique in that doctors have learned to prevent it in many cases! As for none of the other congenital infections, effective preventive measures have been developed for this, which can significantly reduce the risk of infection.
Each woman during pregnancy is twice tested for HIV. When it is detected, preventive measures are taken. They include three components. The first is the taking of specific medications. Their number (one, two or three) and the length of the pregnancy, from which the reception should begin, is determined by the doctor. The second is the choice of the method of delivery. As a rule, the HIV-positive woman is shown a cesarean section. The third is the rejection of breastfeeding. An HIV-positive mother should feed the baby not with the breast, but with adapted milk formulas. All these activities, including the provision of drugs and milk formulas, are free of charge.
The risk of mother-to-child transmission of HIV varies by region, which is probably related to the defects in the provision of preventive measures. The main problem is that HIV-positive pregnant women often either do not believe in the effectiveness of prevention, or do not feel responsible for the health of the unborn child. If an HIV-positive woman decides to give birth, then it is simply criminal to refuse to carry out preventive measures. In 2008, the Ministry of Health approved the instruction "Provision of medical care for HIV-positive pregnant women and children born to HIV-infected mothers", which clearly prescribes for the doctor how, in accordance with modern international standards, to prevent the transmission of HIV from mother to child in different clinical situations.
A child can become infected with HIV either through transfusion of contaminated donor blood or through contaminated medical equipment. It was medical interventions that led to nosocomial infections of children in the late 1980s in Russia (Elista, Rostov-on-Don) and Eastern Europe (Romania). These outbreaks, in which dozens of children, mostly newborns, were infected, stirred the world public and made them take the problem seriously. Fortunately, at present, health care facilities traditionally maintain a high level of sanitary and epidemiological regime when working with blood, which has made it possible to avoid cases of nosocomial infections of children. Also, no children were infected with transfusion of blood components, which indicates the quality of the work of our donor service. Adolescents can become infected with HIV through sexual contact and with the use of injecting drugs.
About HIV treatment
Specific treatment of HIV infection in children - antiretroviral therapy (APT) - has been conducted in Russia since the 90s. The wide availability of APT has appeared since 2005 and is associated with the launch of the project "Prevention and Treatment of HIV / AIDS in the Russian Federation", implemented by the United Nations Development Program and the Ministry of Health of our country.
Treatment can suppress the reproduction of the virus in the body, against which the immune system is restored, and the stage of AIDS does not occur. Treatment is a daily intake of drugs. This is not a "handful" of tablets that should be taken strictly on the clock, as in the 90's, but only a few tablets or capsules taken in the morning and in the evening. Very important is the constant daily intake of drugs, because even a short break in the control of the virus leads to the development of resistance to treatment. Children with HIV usually tolerate the treatment well and lead an active full-fledged life against it.
Currently, HIV-infected children are allowed to stay in a children's team. The disease is not a contraindication for visiting a kindergarten or school. After all, for children with HIV, the problem in society is not paramount. It is important for them to be among their peers, to lead a normal active life and develop normally.