Abstract
Children and adolescents infected and affected by HIV face similar challenges. Each must cope with: physical illness and medical regimens to optimize health; mental health symptoms and fears of premature death; shifts in their social relationships, including deciding when, how, and what to disclose regarding one’s serostatus; reducing risky lifestyles, especially alcohol and drug abuse; and concurrent partnerships with seronegative partners. This chapter describes the developmental and epidemiological patterns, which concentrate these challenges in the poorest populations in low- and middle-income countries. Family- and community-based structural interventions are the strategy for improving the outcomes for pediatric HIV over time. The intervention literature is reviewed and summarized, with structural interventions outlined for the future.
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Annotated Bibliography
Bryson, Y. J. (1996). Perinatal HIV-1 transmission: Recent advances and therapeutic interventions. AIDS, 10(Suppl 3), S33–S42.
In HIV research, 1996 represents a significant year in breakthroughs in perinatal transmission of HIV during pregnancy and childbirth. Dr. Bryson also reviews the landmark AIDS Clinical Trials Group 076 which formally cited zidovudine as a viable form of prevention of perinatal transmission.
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Dr. Cohen and his team definitively demonstrated that HIV transmission is preventable with early initiation of antiretroviral therapy among serodiscordant couples. This HIV Prevention Trials Network is a large scale randomized controlled trial conducted across nine of the most HIV-prevalent countries, ultimately regarded as evidencing proof-of-concept for HIV treatment as prevention.
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The Philani Plus intervention in South Africa validates the World Health Organization recommendation of task shifting and the benefits of paraprofessionals in HIV prevention and care in low- and middle-income countries. This manuscript provides a comprehensive understanding of Dr. Rotheram’s Mentor Mothers, and has since been adopted in several sites.
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In 2014 the Joint United Nations Programme on HIV/AIDS (UNAIDS) published its targets for the future direction of HIV and goals to be achieved by 2020: 90% of people living with HIV aware of their status; 90% on treatment; 90% virally suppressed. This report guides current research and practice and set worldwide benchmarks.
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This chapter was completed with support by grants from the National Institutes of Health MH58107, 5P30AI028697, and MH111391 and from the National Institute of Alcohol and Alcohol Abuse AA022919 and AA017104.
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Youssef, M.K., Harris, D., Rotheram-Borus, M.J. (2016). The Impact of Pediatric HIV on Families. In: Chenneville, T. (eds) A Clinical Guide to Pediatric HIV. Springer, Cham. https://doi.org/10.1007/978-3-319-49704-4_5
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