Читать книгу Lifespan Development - Tara L. Kuther - Страница 191

Mother-to-child transmission of HIV has declined as scientists have learned more about HIV. However, it remains a worldwide problem especially in developing nations where cultural, economic, and hygienic reasons prevent mothers from seeking alternatives to breastfeeding, a primary cause of mother-to-child transmission of HIV.

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The rate of mother-to-child transmission of HIV has dropped in recent years as scientists have learned more about HIV. The use of cesarean delivery as well as prescribing anti-HIV drugs to the mother during the second and third trimesters of pregnancy, as well as to the infant for the first 6 weeks of life, has reduced mother-to-child HIV transmission to less than 2% in the United States and Europe (from over 20%) (Torpey, Kabaso, et al., 2010). Aggressive treatment may further reduce the transmission of HIV to newborns, and research suggests that it may even induce remission (National Institute of Allergy and Infectious Diseases, 2014; Pollack & McNeil, 2013; Rainwater-Lovett, Luzuriaga, & Persaud, 2015). However, in developing countries, such interventions are widely unavailable. Worldwide, mother-to-child HIV transmission remains a serious issue. For example, in Zambia, 40,000 infants acquire HIV each year (Torpey, Kasonde, et al., 2010). Treating newborns is critical, although not always possible. Worldwide, 20% to 30% of neonates with HIV develop AIDS during the first year of life and most die in infancy (United Nations Children’s Fund, 2013).

Globally, breastfeeding accounts for 30% to 50% of HIV transmission in newborns (Sullivan, 2003; World Health Organization, 2011). The World Health Organization (2010) recommends providing women who test positive for HIV with information about how HIV may be transmitted to their infants and counseling them not to breastfeed. Yet cultural, economic, and hygienic reasons often prevent mothers in developing nations from seeking alternatives to breastfeeding. For example, the widespread lack of clean water in some countries makes the use of powdered formulas dangerous. Also, in some cultures, women who do not breastfeed may be ostracized from the community (Sullivan, 2003). Balancing cultural values with medical needs is a challenge.

Children with HIV are at high risk for a range of illnesses and health conditions, including chronic bacterial infections; disorders of the central nervous system, heart, gastrointestinal tract, lungs, kidneys, and skin; growth stunting; neurodevelopmental delays, including brain atrophy, which contribute to cognitive and motor impairment; and delays in reaching developmental milestones (Blanchette, Smith, Fernandes-Penney, King, & Read, 2001; Laughton, Cornell, Boivin, & Van Rie, 2013; Sherr, Mueller, & Varrall, 2009).