Why Pediatric AIDS?

Why It Matters Why Mothers? Stories of Hope

When Elizabeth Glaser contracted HIV in a blood transfusion in 1981 while giving birth to her daughter, Ariel there was no knowledge of pediatric AIDS. She and her husband, Paul, later learned that Elizabeth had unknowingly passed the virus on to Ariel through breast milk and that their son, Jake, had contracted the virus in utero.

Ariel lost her battle with AIDS in 1988. Fearing that Jake's life was also in danger, Elizabeth rose to action. With the help of two dear friends she founded the Pediatric AIDS Foundation to bring hope to children with HIV/AIDS and their families. Upon Elizabeth's passing in 1994 the Foundation was renamed the Elizabeth Glaser Pediatric AIDS Foundation.

As experienced by the Glaser family first-hand in the late 1980s, drug companies and health agencies had little idea the extent to which HIV was prevalent among children. The only drugs on the market were for adults; nothing had been tested or approved for children.

Today, thanks to breakthrough research and innovative programs aimed to prevent mother-to-child transmission, we are closer than ever before to ending pediatric AIDS. With your help, and working together, we can end pediatric AIDS in this generation.

What is HIV?

In simple terms: HIV is the virus that causes AIDS and can be transmitted during sexual intercourse; from mother to baby in pregnancy, childbirth, and breastfeeding; or through exposure to blood containing the virus.

In greater depth: The human immunodeficiency virus (HIV) is the agent that causes acquired immunodeficiency syndrome (AIDS). The virus can be transmitted during sexual intercourse, pregnancy (i.e., from mother to baby), childbirth, breastfeeding, or exposure to blood containing the virus, such as through use of contaminated needles or blood products.

In the body, the virus enters vital immune cells called CD4 cells. CD4 cells coordinate the immune system's fight against infections. HIV causes destruction and impaired function of the body's CD4 cells—and in the absence of treatment, HIV continues to replicate within the body, eventually leading to severe immunodeficiency, chronic illness, and death.

What is AIDS?

In simple terms: AIDS is an advanced stage of HIV infection, which develops after excessive damage to the immune system.

In greater depth: Acquired immunodeficiency syndrome (AIDS) develops after prolonged damage to the immune system caused by HIV and represents an advanced stage of HIV infection. In most cases, a person living with HIV eventually develops AIDS, often after being infected for many years.

AIDS is characterized by severely diminished immune system function, which means that the body is highly vulnerable to infections and cancers that are typically fought off by a healthy immune system. As defined by the United States Centers for Disease Control and Prevention, a person has AIDS when HIV has drastically reduced his or her CD4 cell count (CD4 cells coordinate the immune system's fight against infections), or when a person living with HIV is diagnosed with at least one opportunistic infection (i.e., an infection that does not normally occur in someone with a healthy immune system) or other AIDS-defining condition.

How do children become infected with HIV?

In simple terms: Most infections result from a mother passing the virus to her child during pregnancy, childbirth, or breastfeeding.

In greater depth: More than 90 percent of HIV infections in children result from mother-to-child transmission, where the virus is passed from a mother living with HIV to her baby during pregnancy, childbirth, or breastfeeding. While the precise mechanisms for viral transmission during pregnancy are not fully understood, the risk of this form of transmission increases in direct relation to the severity of the mother's HIV infection.

How does HIV affect children?

In simple terms: Many children with HIV get sick more quickly than adults because their immune systems are not fully developed.

In greater depth: Because children's immune systems are still developing, they are particularly vulnerable to HIV infection. Children living with HIV generally get sick more rapidly than adults. They may experience the same common pediatric infections as HIV-negative children, but children living with HIV cannot fight these infections as effectively.

Common infections in HIV-positive children include ear and sinus infections, sepsis, pneumonia, urinary tract infections, intestinal illness, skin disease, and meningitis. In developing countries in particular, tuberculosis, diarrhea, and respiratory illnesses are common in HIV-positive children.

How can HIV infection in children be prevented?

In simple terms: Transmission of HIV from  a mother to her child can be prevented during pregnancy, childbirth, and breastfeeding through the use of antiretroviral therapy (ART) and antiretroviral (ARV) drugs.

In greater depth: Currently available approaches to preventing HIV infections in infants can reduce the risk of mother-to-child transmission to less than 2 percent. The most effective method for preventing mother-to-child HIV transmission is by initiating lifelong antiretroviral therapy (ART) as early as possible in treatment-eligible HIV-positive pregnant women and providing effective prophylaxis for those who are not eligible for treatment.

In cases where a woman is not eligible for ART or ART is not available, a shorter, simplified course of antiretroviral (ARV) drugs can be given to the mother, starting early in pregnancy, and to her infant immediately following delivery. Extending the course of ARVs through the breastfeeding period in locations where breastfeeding is important to the survival of the infant also decreases the likelihood of HIV transmission through breast milk.

Proven highly effective at preventing HIV transmission from mother to child, ARVs decrease the amount of virus in the mother's bloodstream (i.e., viral load), thus reducing the risk that she will transmit the infection to her infant. These drugs also have a protective effect before and after birth, helping the child to better resist HIV infection.

According to the United Nations, the use of ARVs has averted an estimated 350,000 new HIV infections in children over the last 15 years, the vast majority since 2005. Yet, only 48 percent of HIV-positive pregnant women worldwide are receiving this critical intervention (UNAIDS, World AIDS Day Report, 2011).

How is HIV infection in children treated?

In simple terms: Children who are diagnosed early and have access to antiretroviral therapy (ART) have a greater ability to fight off infection and slow the progression of the disease.

In greater depth: There is no cure for HIV infection. However, early infant diagnosis is critical since ART, when administered as early as possible in the course of infection, can help HIV-positive children lead longer, healthier lives. Taken every day, these medicines can drastically reduce the concentration of HIV in the bloodstream and improve the ability to fight off other infections, thereby dramatically slowing the progression of the disease.

Sadly, most children still do not have access to these lifesaving medications. It is estimated that almost half of HIV-positive children will die before their second birthdays in the absence of treatment (UNAIDS, Towards Universal Access 2010).