Nutrition

Nutrition and HIV/AIDS

Undernutrition is common among people living with HIV/AIDS. UNICEF's nutritional priorities for people infected or affected by HIV/AIDS are threefold: encouraging correct infant feeding practices and supporting HIV-infected mothers to appropriately feed their children, supporting the nutritional needs of mother and children living with HIV, and assisting the millions of children orphaned or made vulnerable by the virus.

The UN estimates that:
• Globally, an estimated 3.3 million children aged 0-14 are living with HIV in 2012
• The number of children under 15 who were newly infected in the 22 priority countries fell by 36 per cent, from 360,000 in 2009 to 230,000 in 2012
• An estimated 1.5 million pregnant women were living with HIV in low and middle income countries in 2012
• Approximately 2.1 million (1.7 million–2.8 million) adolescents were estimated to be living with HIV globally in 2012, more than 80 per cent of them in sub-Saharan Africa  
• While the number of global AIDS-related deaths for all ages fell by 30 per cent between 2005 and 2012, among adolescents they increased by 50 per cent in that period
• In 2012, 17.8 million children lost one or both parents to AIDS. 15.1 million in sub-Saharan Africa

Prevention of Mother to Child Transmission (PMTCT) of HIV and Infant Feeding

As a result of recent progress in preventing the mother to child transmission, fewer infants are acquiring HIV. In 2012, coverage of antiretroviral drugs (ARVs) for pregnant women living with HIV reached 62 per cent in the 22 priority countries in the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (the ‘Global Plan’). Yet, approximately 230,000 (180,000–300,000) children – or 630 (540–760) per day – were newly infected with HIV in these countries during 2012. In low- and middle-income countries, about 260,000 new infections among children occurred in 2012, but between 2005 and 2012, more than 850,000 HIV infections in children were prevented in low- and middle-income countries. ^^^^^^^ . In the absence of any preventative interventions, infants born to and breastfed by HIV-infected women have roughly a one-in-three chance of acquiring infection themselves. This can happen during pregnancy, during labour and delivery or after delivery through breastfeeding. The risk of mother-to-child-transmission of HIV is about 15%–30% if the mother does not breastfeed the child. With prolonged breastfeeding, the likelihood of infection can be as high as 45%. Timely administration of antiretroviral drugs significantly reduces the risk of HIV transmission.

Breast milk contains all the necessary nutrients for newborns and young infants and provides protection from childhood diseases such as diarrhea and pneumonia. However, breast milk also contains the virus and potentially infects the breastfed infant. HIV-infected mothers used to face an agonizing choice when deciding how to feed their infants. If a mother does not breastfeed, her infant will face a six times greater chance of dying in his or her first two months of life from childhood disease, but if she chooses to breastfeed, her infant may acquire the virus. But, the most recent scientific evidence has shown that antiretroviral drugs reduce the risk of transmission and that mothers living with HIV can now safely breastfeed their infants.

HIV’s high nutritional toll

The HIV/AIDS pandemic combined with drought, floods, soaring food prices, decades of conflict, economic decline and cuts in social services, have overwhelmed families in many parts of sub-Saharan Africa, leaving them with few coping mechanisms. Weight loss and low micronutrient levels are associated with increased progression to AIDS in adults living with HIV. This crisis in Africa has underscored the dire nutritional needs of all children who are HIV positive or affected by HIV/AIDS, such as orphans and those living in households with infected family members.  Many are left to fend for themselves, while others live with HIV-infected parents who can no longer provide food for their families. Undernutrition rates are increasing and orphans are hardest hit.  Without treatment almost 50 per cent of infected infants will die before age two. In 2012, 646,852 children 0-14 aged were receiving antiretroviral therapy in low and middle income countries. Many HIV-infected children also suffer from undernutrition.

UNICEF’s response

Fighting HIV/AIDS is one of UNICEF's five organizational priorities. Nutrition programming in the context of HIV is focused on the prevention of mother-to-child transmission in breastfeeding and on care and support for infected mothers and HIV-exposed and infected children. Strategies include: providing voluntary, confidential testing and infant feeding counseling for pregnant women, helping governments develop infant and young child feeding policies that encourage early and exclusive breastfeeding and include HIV guidelines, protecting breastfeeding, and promoting optimal infant feeding in hospitals. UNICEF also addresses the nutritional needs of the growing number of HIV-positive pregnant and lactating women and children who are infected with the virus, orphaned, or living with an HIV-infected parent. Read more in the page “HIV’s high nutritional toll”.


 

 

Children and AIDS: Fourth Stocktaking Report, 2009

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