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1 2 .Learning objectives: At the end of the session the participant will be able to: Understand HIV transmission in children How it does not spread What can be done to prevent HIV in Children Training methodology: Presentation Participatory game Session content How HIV spreads and does not spread among children HIV prevention among children Signs and symptoms in children Time : 45minutes Submodule 5.
Few review What is HIV? What is AIDS? What is the difference between HIV and AIDS Where is HIV found in human body Which body fluids are infective Most infective to least infective body fluids What are antigen and antibody What happens when HIV enters human body Submodule 5.1 3 .
995 AIDS cases 5596 are children Of the 2.general population is 0. UNGASS report 2008] HIV prevalence .36% Perinatal transmission is 3.National &TN State scenario India o o o o o Of the 1.1 4 .8% 16% of all new infections are among children < 15years Tamilnadu State TN ART centers have registered 7000 children but estimated No: is around 7500 HIV +ve : affected children is 1:10.5 million PLWH 94. which means there are around 75000 affected children What is interesting state programs reach to infected children alone Submodule 5.000 are children [Source: Technical report on HIV estimation.24.
Vulnerable children. HIV exposed child refers to infants born to mothers living with HIV. Is living with HIV/AIDS. or a person below the age of 18 years of age. or lost extended family member/s and/or sibling/s to AIDS. or one/both parents living with HIV/AIDS. Submodule 5. or who is orphaned by AIDS. An HIV infected child is defined as a child living with HIV/AIDS An orphan is defined as a child under age 18 who has lost one or both parents.1 5 . between the age group of 0 ± 17 years.are children who are more vulnerable in terms of the harm/danger/risk to their survival/development and participation.Operational definitions A child is defined as any person. An HIV affected child is defined as a child who has: Family member living with HIV/AIDS. until HIV infection in the infant or child is reliably excluded and the infant or child is no longer exposed through breastfeeding. Lost a parent or significant other such as guardian or care provider due to AIDS.
1 6 .HIV transmission in children HIV transmission occurs through 3 modes: Established modes of transmission Possible but uncommon modes of transmission Impossible routes of transmission Submodule 5.
during or after birth Exposure to contaminated blood as a result of transfusion of blood not screened for HIV ± hemophilic or thalassemic child Child sexual abuse and assault Use of contaminated syringe & needle ± rarely child needle users Submodule 5.Established modes of transmission in children Vertical transmission ± from infected mother to child before.1 7 .
plates and eating utensils Shaking hands Touching or hugging or kissing a child with HIV/AIDS Mosquitoes and other insect bites Wearing clothes of infected child Using telephones Using toilets used by children with HIV Swimming in pools used by children with HIV/AIDS Donating blood Submodule 5.1 8 . glasses.Impossible routes of HIV transmission Socializing or casual living with a child living with HIV/AIDS Coughing or sneezing Sharing cups.
NNRT group of drug Nevirapine alone to mother at time of onset of labour and to child with in 72hours bring down the risk of HIV transmission to the child while the triple drug HAART therapy to mother if mother¶s CD 4 count is below <200cells/cumm bring down the risk of HIV transmission to the child and also provides quality life for the mother Presence of STI or RTI increases the risk and hence must be treated completely during ANC period.Prevention of HIV in children HIV spread route Prevention action In Utero transmission Administering ART to the mother is a key intervention in prevention.1 9 . A vaginal wash is also recommended before delivery Vaginal delivery Submodule 5.
One needs to explain the risk associated with breast feeding. but milk supply will not be sufficient as sucking reflex is the most important for initiating milk secretion and when this is not there adequate supply may not be there Submodule 5. To breast feed or not is the choice of the couple. safe alternative feeding alone. to which many may be unwilling.couple counseling ± infant feeding counseling through breast milk to mother during ANC period itself. Expressed breast milk can be heat treated to 54 degrees and this destroys the virus. explain about safe breast feeding.1 10 . Wet nurses have been tried but we need to confirm her HIV status before allowing her to feed.Prevention of HIV in children HIV spread route Prevention action Transmission Counseling support .
Blood to be obtained from licensed blood banks only and to check if the negative certificate has been given Child sexual abuse and assault By strengthening child protection with in family. Child who has been abused should be started on ART as PEP Transmission through needles Use oral drugs always.Prevention contd «. Use only disposable needles and proper disposal of needles is also important.1 11 . or school or institution. HIV spread route Prevention action Transmission through blood and Screened blood should be got when needed. Adhere to universal precautions Submodule 5. Donor blood products whose HIV status is known needs to donate. in community.
Pediatric signs and symptom Major Signs Unexplained weight loss/ abnormally slow growth pattern or failure to thrive Chronic diarrhea longer than one month not responding to routine treatment Prolonged fever longer than one month of unexplained origin Minor Signs Generalized Lymph adenopathy Oropharyngeal Candidiasis Repeated common infections like otitis media.1 12 . Persistent cough Generalized dermatitis Confirmed maternal HIV infection Submodule 5. pharyngitis etc..
Prolonged unexpected fatigue. Submodule 5. Unusual or strange behavior.Tumor. Blind spots in vision/decreased vision or blindness.Joint swelling. Joint pain. Joint .Swollen gums. Mouth . Headache. Joint stiffness.Remember child may have anyone of the following complaints General . including constipation. stress and tension. Speech impairment Chest . Eye .. diarrhea. Chills.1 13 . indigestion or other gastrointestinal problems. lethargic movement. Decreasing intellectual function. Slow.Shortness of breath.Blurred vision/Double vision (Diplopic)/light sensitivity. Brain . Abdomen . Sore throat.Changes in bowel habits. Chest pain/Back pain/Abdominal pain Muscle pain. Memory loss. sluggish. Anxiety. Loss of appetite. Excessive sweating (night sweats).