April 28, 2021 | Written By: Nurul Afiqah
According to data from the United Nations Children’s Fund (UNICEF), of an estimated 38.0 million people living with HIV worldwide in 2019, 2.8 million were children aged 0 to 19 years old. In 2019, every day, about 880 children were infected with HIV and about 310 children died from AIDS that is mostly due to inadequate access to HIV prevention, treatment and care services.
In the same year, the estimated number of people living with HIV in Malaysia was around 87000 people. Yet, based on data from the National Surveillance System, nearly 78000 of them, i.e. 0.4% are children under the age of 15. The estimated incidence rate per 1000 of the uninfected population shows an increase in the last two years.
How can children get HIV? Are their symptoms differ from adults? Follow this article for more information on HIV in children.
What are the Symptoms/ Signs of HIV in Children?
Not all children with HIV will develop symptoms. The symptoms or signs of HIV in children vary depending on their age.
HIV status may be difficult to identify in infants. However, some of the symptoms of HIV infection in infants may include:
Failure to thrive. Babies with HIV can experience a delay in growth in terms of weight gain and height.
Swollen abdomen. This is due to swelling of the liver and spleen.
Swollen lymph nodes
Oral candidiasis. It is a fungal infection in the mouth that causes white spots on the cheeks and tongue.
Children & Adolescents
Symptoms of HIV in children or teens may include the following:
Frequent fungal infections of the vagina
Enlarged liver or spleen
Memory and concentration problems
Benign or malignant tumours
Children with untreated HIV, are more vulnerable to infections and other diseases such as:
Pelvic inflammatory disease
Learn How HIV Is Transmitted To Children
Mother-to-child HIV transmission is also known as vertical transmission. HIV transmission from an HIV-positive mother to a child can occur during:
According to the World Health Organization (WHO), if no intervention or treatment is given, the rate of mother-to-child transmission of HIV ranges from 15% to 45%. However, the rate can be reduced to less than 5% with antiretroviral therapy during pregnancy, childbirth and breastfeeding.
Using the same needle to get blood or give medication to multiple patients can spread HIV. There is a possibility that the blood left in the syringe is from someone infected with the virus. The virus in the blood has a lifespan of 42 days, even if it is left on the syringe, depending on room temperature.
Although sexual contact is commonly associated with adults, children have no exception. Children or adolescence have the potential to get involved in unsafe sexual activity. In addition, children can also get infected with HIV through sexual abuse or rape.
In 2019 Out of the Shadows Index on responses to child sexual abuse and exploitation, Malaysia ranked 23 out of 60 countries, with a score of 54.5. This overall score measures how well the country’s environment has an increased risk of exploitation and sexual abuse of children; how it helps them seek justice; if the government is committed and able to address the problem of sexual abuse against children as well as assess the role of society in addressing the problem. In the Southeast Asian region, after the Philippines, Malaysia ranks ahead of Cambodia and Indonesia.
Sexual intercourse is the most common way of transmission of HIV infection. The virus can be spread during vaginal, oral, or anal sex without a condom or other protection. Unprotected sexual intercourse not only has the potential to spread HIV but other sexually transmitted diseases as well.
HIV can also be transmitted through blood infected with the virus. Blood transfusion also has the potential to transmit HIV to children. However, due to the strict procedures of blood donation nowadays, the risk of blood transfusion as a cause of HIV transmission is decreasing.
Treatment For Children With HIV
Although no drug can completely cure HIV infection, prompt diagnosis of HIV infection in children can help provide them with treatment and improve their quality of life. The problem of HIV in children can be addressed by giving a combination of antiretroviral drugs (ART/HAART) that can overcome the symptoms of infection while boosting the body's immune system.
Children will be given medications similar to adults’ medications. However, not all antiretroviral drugs or HAART (Highly Active Antiretroviral Therapy) for adult patients, whether licensed or approved, can be used in children. Such medications are also often not available in forms suitable for children. Although antiretroviral drugs in liquid form have been developed, they have not been confirmed practical for use because there are several taboos on HAART drugs that must be observed. HAART medications tend to smell unpleasant, need to be taken in large quantities, require refrigeration and will not last long after opening.
Therefore, for children with HIV, they need further advice and information from experts as well as support and monitoring from parents or guardians so that appropriate treatment can be given.
How To Prevent HIV In Children
Antiretroviral drug therapy can be given to pregnant women, which has been shown to reduce the transmission of HIV to the unborn baby.
Cesarean delivery is also recommended to reduce the transmission of HIV to the baby during childbirth.
Strict monitoring and prohibition of free sexual intercourse, in addition to curbing the problem of sexual abuse among children.
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