Article

PEPFAR Scale-up of Pediatric HIV Services: Innovations, Achievements, and Challenges

ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA.
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.56). 08/2012; 60 Suppl 3:S105-12. DOI: 10.1097/QAI.0b013e31825cf4f5
Source: PubMed

ABSTRACT

HIV/AIDS has had a profound impact on children around the world since the start of the epidemic. There are currently 3.4 million children under the age of 15 years living with HIV globally, and more than 450,000 children currently receiving lifesaving antiretroviral treatment. This article describes efforts supported by the President's Emergency Plan for AIDS Relief (PEPFAR) to expand access to treatment for children living with HIV in high-burden countries. The article also highlights a series of case studies that illustrate the impact that the PEPFAR initiative has had on the pediatric HIV epidemic. Through its support of host governments and partner organizations, the PEPFAR initiative has expanded HIV testing and treatment for pregnant women to reduce vertical transmission of HIV, increased access to early infant diagnosis for HIV-exposed infants, improved training and resources for clinicians who provide pediatric care and antiretroviral treatment, and, through public-private partnerships with pharmaceutical manufacturers, helped increase the number of medications available for the treatment of HIV-infected children in resource-limited settings.

3 Followers
 · 
30 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The global epidemiology of HIV/AIDS is rapidly evolving in low and middle income countries. Women and adolescent females in sub-Saharan Africa are at risk of HIV acquisition due to a myriad of complex biological, behavioral and structural factors. Primary HIV infection among women primarily drives the pediatric HIV epidemic. Postnatal transmission of HIV during breastfeeding is a major concern in LMIC, particularly in sub-Saharan Africa where breastfeeding remains the only feasible, safe and culturally acceptable infant feeding choice. Given the remarkable discoveries in biomedical interventions to prevent sexual transmission of HIV and MTCT during breastfeeding, there is now a unique opportunity to rapidly implement combination HIV prevention packages, provide quality prevention of mother-to-child HIV transmission services, and improve maternal and infant survival. Although rapid scale-up of PMTCT interventions has occurred in sub Saharan Africa in the past five years, significant challenges remain towards reaching the ambitious goal of virtual elimination of new HIV infections among children on a global scale by 2015 and keeping their mothers alive. Rapid translation of scientific discoveries into policy and practice in conjunction with strong commitment from national leadership and global partners is crucial to end the pediatric AIDS and achieve a HIV-free generation.
    No preview · Article · Feb 2013 · Current HIV research
  • [Show abstract] [Hide abstract]
    ABSTRACT: HIV/AIDS has become a chronic and manageable disease owing to the remarkable advancement in medication, and it is now suggested that a palliative approach should be integrated into the trajectory of the disease to alleviate patients' psychosocial distress and optimally improve their quality of life.This article synthesises a body of literature to highlight several clinical and systematic challenges that should be addressed in implementing a palliative approach to care for HIV/AIDS patients. They involve pain and symptom management, health-care providers' perceptions of HIV/AIDS, patients' beliefs about palliative care, variability in informal care resources, socioeconomic and demographic determinants of palliative care, and difficulties in evaluating the effectiveness of palliative care. To inform current practice in the palliative care domain, responses to the identified challenges are discussed. A disease stage-specific model is also presented to respond to the prolonged course of HIV/AIDS.
    No preview · Article · May 2013 · International journal of palliative nursing
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In 2011, Joint United Nations Programme on HIV/AIDS announced a plan to eliminate new HIV infections among children by 2015. This increased focus on the elimination of maternal to child transmission (MTCT) is most welcome but is insufficient, as access to prevention of MTCT (PMTCT) programming is neither uniform nor universal. A new and more expansive agenda must be articulated to ensure that those infants and children who will never feel the impact of the current elimination agenda are reached and linked to appropriate care and treatment. This agenda must addresses challenges around both reducing vertical transmission through PMTCT and ensuring access to appropriate HIV testing, care, and treatment for all affected children who were never able to access PMTCT programming. Option B+, or universal test and treat for HIV-infected pregnant women is an excellent start, but it may be time to rethink our current approaches to delivering PMTCT services. New strategies will reduce vertical transmission to less than 1% for those mother-infant pairs who can access them allowing for the contemplation of not just PMTCT, but actual elimination of MTCT. But expanded thinking is needed to ensure elimination of pediatric HIV.
    Full-text · Article · Nov 2013 · AIDS (London, England)
Show more