Stuart Gan Memorial Lecture 2002. HIV/AIDS in children

The incidence of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) in children has risen steadily over the years and has become an increasing cause of morbidity and mortality during childhood. More than 90% of all children with HIV infection acquired their infection at birth from HIV-infected mothers. With increasing evidence of heterosexual HIV transmission, the number of infected women and consequently their children is increasing. The transmission rate of HIV from mother to infant varies from 20% to 40%. Children can be affected directly through HIV infection and AIDS, and indirectly by the effects of their parents' HIV infection, including being orphaned, discrimination, infant abandonment and negative impact on children's education. Another concern regards children who are most vulnerable to HIV infection and AIDS, such as child prostitutes and children in difficult circumstances. Recommended actions include prevention of parental HIV infection, prevention of mother-to-child HIV transmission, addressing child prostitution, prevention of child labour and improving work conditions, assistance to street children, addressing discrimination, solving the problem of children orphaned by AIDS, reducing HIV-related child abandonment and creating new roles for schools in reducing negative social impact. Although the largest number of HIV-infected persons are from sub-Saharan Africa, the annual incidence of HIV infection in Asia is escalating alarmingly. As reported by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization in December 2001, HIV infection has already killed more than 20 million people worldwide since the beginning of the epidemic and has infected more than 40 million people; almost half of them were women. There are at least 7 million people living with HIV/AIDS in the Asia-Pacific region. The numbers of HIV-infected women and children are increasing at an alarming rate. Over 1 million children are HIV-infected; in the year 2000 alone, 600,000 children acquired HIV infection.