Vatican City (Fides Service) –
We known that HIV/AIDS is mainly transmitted through sexual relations.
Adults are responsible for their actions of which they must face the
consequences. But how does this virus if not by adults infect infants
and children? The suffering and death of children always raises questions:
why? Why should a newborn child suffer from AIDS? Why are children
condemned to be orphans because their parents died of HIV/AIDS? “Fathers
who eat bitter grass spoil their children’s teeth?» But
what is society doing to help these unfortunate children?
This report prepared by Father Jacques SIMPORE, Molecule Genetist,
Member of the Pontifical Academy for Life Vita, has three parts:
1 – How children are infected by HIV/AIDS
2 – Epidemology and problems of HIV/AIDS among children under
15 in the world.
3 – Activity of three Camillan Centres which work to prevent
mother/child transmission applying the PTME project (Prevention Transmission
Mother Child)
1 - How children are infected by HIV/AIDS
Bio-medical science lists three modes of HIV transmission:
- sexual transmission;
- blood transfusions or penetration to a healthy organism of HIV infected
biological fluids (sperm, vaginal secretion, blood)
- mother/child.
The most frequent mode of HIV/AIDS transmission mother/child may take
place in the womb through the placenta; at the moment of birth; during
breast-feeding.
Many factors increase the risk of infection: the quantity of the viral
charge present in the mother’s blood in the, amniotic fluid,
vaginal secretion in mother’s milk. Co-infections (IST: infections
sexually transmissible): HCV, HBV, HGV, HTLV, HHV8… other factors,
breaking of membranes increase risk of mother/child HIV transmission.
Average global rate of mother/child HIV transmission in Africa varies
from 30% to 35% while in the West it is almost 0%.
What can be done to prevent mother/child HIV transmission?
- Education of adults and formation of women aged 18 to 42;
- Treating pregnant mothers with antiretroviral drugs such as nevirapina;
- Caesarean delivery for HIV+ mothers;
- Stop HIV + mothers from breast-feeding. The early milk, colostrum,
with a high viral charge must be avoided at all costs.
- hygiene: infants and children can also be infected in different
ways through blood transfusions and contact. In some cultures there
is a spreading opinion that by having sexual relations with a virgin
an HIV+ man will be cured. This is leading many HIV+ positive men
seeking a “cure”, to be sure the partner is virgin,
commit the ignominious act, contrary to nature, of taking advantage
of new-born girl babies.
Because of irresponsible behaviour of men and women today AIDS has
reached a tragic peak of 42 million HIV+ persons many of who are
infants and children under 15.
2 – Epidemology and problems of HIV/AIDS among children under
15 in the world. , ,
The extent of HIV varies according to continent and country there
is not homogeneity of infection.
Unless we have special interventions, programmes to prevent and
eliminate AIDS we will see:
- HIV will spread relentlessly;
- ever greater numbers of HIV+ children infected mother/child;
- increasing number of infant and children AIDS orphans
We look at 1997 reports from UNAIDS/WHO and from the website www.avert.org
in 2003.
In 6 years 1997 to 2003:
- Number of HIV+ children increased 18.64%,
- Number of children who died of HIV increased 8.69%,
- Number of AIDS orphans increased by 70.73%. (Table number 1).
The number of HIV+ children grows and many become orphans when
their parents die of AIDS. Table 1 shows that in 1997 the percentage
of children HIV+ who died was 20.00% compared to 16.67% in 2003.
The decrease in the number of children due to AIDS is thanks to
treatment in recent years promoted by UNICEF, WHO and NGOs.
| TABLE 1 |
| Report UNAIDS/WHO 1997 |
children HIV(+) under 15 |
Total infection HIV |
% children HIV (+) under 15 |
| Persons living with HIV in 1997 |
1,100,000 |
30,600,000 |
3.59% |
| Persons infected with HIV in 1997 |
590,000 |
5,800,000 |
10.17% |
| Persons killed by HIV until 1997 |
2,700,000 |
11,700,000 |
23.08% |
| Persons killed by HIV in 1997 |
460,000 |
2,300,000 |
20.00% |
| Number of orphans |
8,200,000 |
|
|
| www.avert.org/aroundworld.htm
Statistics 2003 |
children HIV(+) under 15 |
Total infection HIV |
% children HIV (+) under 15 |
| Persons living with HIV in 19972003 |
2,500,000 |
40,000,000 |
6.25% |
| Persons infected by HIV in 2003 |
700,000 |
5,000,000 |
14.00% |
| Persons killed by HIV until 2001 |
4,300,000 |
21,800,000 |
19.72% |
| Persons killed by HIV in 2003 |
500,000 |
3,000,000 |
16.67% |
| Number of orphans |
14,000,000 |
|
|
In certain countries of Sub-Saharan Africa the number of AIDS orphans
is very high. In Uganda, Kenya and Zimbabwe for example, 51%, 54%
and 77%. Table 2 shows world statistics.
| TABLE 2 |
| Continent |
Orphans in the world |
AIDS orphans |
% AIDS orphans |
| Africa |
34,294,000 |
11,035,000 |
32.18% |
| Asia |
65,504,000 |
1,827,000 |
2.79% |
| Latin America + Caribbean |
8,166,000 |
578,000 |
7.08% |
| Orphans in the world (2001) |
107,964,000 |
13,440,000 |
12.45% |
3 – Activity of three Camillan Centres which apply PTME project
(Prevention Transmission Mother Child) to prevent mother/child transmission
At Centres such as “Hogar San Camillo” in Lima, Peru,
Rayong Social Centre in Thailand and Ouagadougou Medical Centre
in Burkina Faso run by the Catholic religious Camillan Fathers WHO,
UNICEF and the Catholic Church work to prevent HIV/AIDS mother/child
infection be giving antiretroviral therapy PTME.
Unfortunately many people are not aware of the danger of HIV/AIDS
mother/child infection.
A survey conducted by the Camillian Fathers in Burkina Faso on 30
June 2001 questioning 511 persons aged 18 to 32 ( 24,81 ±
3,32 average age, 246 girls and 265 boys), revealed the following
:
- 16.75% said they were not aware of HIV/AIDS mother/child infection;
- 35.47% of the girls would marry a HIV+ boyfriend. Only 20.45%
of the boys would marry a HIV+ girl;
- 13.48% wanted a family even if the husband or wife was HIV+ i.
This showed that most young people were not aware of the danger
of HIV/AIDS mother/child infection. Hence the urgent need for formation
for young women and men.
Since May 2002, the Ouagadougou Medical Centre provides private
individual counselling for pregnant women. It offers HIV screening
to all pregnant mothers and to their partners.
All infants born to HIV+ mothers are PCR tested at three months
and the results are encouraging. Thanks to the PTME project many
babies were saved from infection by HIV. For researchers, patients
and public opinion the HIV virus is the symbol of shame, tribulation,
physical suffering and death. In a message to the UN secretary Kofi
Annan dated 26 June 2001, Pope John Paul II said that AIDS is one
of the greatest tragedies of our epoch. The Pope said it is not
only a health problem, it is a disease which has dramatic consequences
on people’s economic, social and political life. . AIDS is
also pathology of the spirit, which destroys not only the body but
the whole person, inter-personal relations, social life, and it
is often a carrier of a crisis in moral values .
Infants and children with HIV/AIDS, children suffering and dying
because of AIDS pose a challenge to science, society and the Church.
Today faced with much resistance to antiretroviral drugs and the
inability of scientists to produce an effective vaccine to prevent
HIV/AIDS mother/child infection what must be our attitude: to surrender
or to fight? “What is the meaning of this proverb that you
recite in the land of Israel: fathers have eaten green grapes thus
their children’s teeth are on edge? As I live, says the Lord
God: I swear that there shall no longer be anyone among you who
will repeat this proverb in Israel” . (AP/JS) (3/4/2004 Agenzia
Fides)
Bibliography
- AIDS around the world, http://www.avert.org/aroundworld.htm
- Grace J., Nduati R., Mbori-Ngacha D., et al. Cervico-vaginal HIV-1
DNA in pregnancy. In: XIth International Conference on AIDS, Vancouver
(Canada). 1996: abstract WeC331. (11)
- Intervention du Saint-Siège lors de la XXVIème session
spéciale de l’Assemblée générale
consacrée à la pandémie du VIH/SIDA, le 27
juin 2001.
- Landesman HS., Kalish AL., Burns ND., et al. Obstetrical factors
and the transmission of human immunodeficiency virus type 1 from
mother to child. N Engl J Med 1996; 334: 1617-23.
- Meda N.; Msellati P.; Van de Perre P.; Salamon R.; Réduction
de la transmission mere-enfant du VIH dans les pays en développement:
stratégies d’intervention disponibles, obstacles à
leur mise en œuvre et perspectives ; Cahiers Santé,
volume 7, Numero 2, pages 115 à 125, mars-avril 1997.
- Message de Jean-Paul II à M. Kofi Annan, du mardi 26 juin
2001 en faveur des personnes vivant avec le VIH/SIDA , Zenit.org
- Peckham CS. Human immunodeficiency virus infection and pregnancy.
Sex Transm Dis 1994; 21 (suppl. 2): S28-31.
- Rouzioux C., Costagliola D., Burgard M., et al. Estimated timing
of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission
by use of a Markov model. Am J Epidemiol 1995; 142: 1330-7.
- Simporé J., Problèmes biomédicaux et éthiques
posés par le mariage de personnes sérodiscordantes,
Camillianum Anno I, terzo quadrimestre Décembre 2001, numéro
3, pp533-544.
- The Working Group on Mother-To-Child Transmission of HIV. Rates
of mother-to-child transmission of HIV-1 in Africa, America and
Europe: results from 13 perinatal studies. J Acquir Immun Defic
Syndr Hum Retrovir 1995; 8: 506-10.
- UNAIDS and WHO, HIV/AIDS situation in mid 1996, http://cmmg.biosci.wayne.edu/asg/Situat96.html
- UNAIDS/HIV, rapport on the global HIV/AIDS epidemic, june 1998,
http://www.who.int/emc-hiv/global_report/data/globrep_e.pdf
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