Nutrition

Nutrition and HIV/AIDS

UNICEF’s nutritional priorities for support to people infected or affected by HIV/AIDS are threefold: helping HIV-infected mothers make informed infant-feeding decisions, supporting the nutritional needs of children living with HIV and assisting the millions of children orphaned or made vulnerable by the virus.

The UN estimates that:
• Globally, children under 15 accounted for an estimated 2 million of the estimated 33 million people living with HIV in 2007.
• An estimated 2.7 million people were newly infected with HIV in 2007. Of these, 370 000 were children under 15.
• An estimated 1.5 million pregnant women were living with HIV in low and middle income countries in 2007
• Sub-Saharan Africa is home to 90 per cent of all children living with HIV, and women represent nearly 60 per cent of HIV infections.
• In 2007, an estimated 2 million people died of AIDS-related causes. Approximately 270 000 of these were children under 15.
• Fifteen million children under the age of 18 have lost one or both parents due to AIDS, including nearly 12 million in sub-Saharan Africa.

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

Every day about 1,000 children under the age of 15 years are infected with HIV. More than 90 per cent of these new infections occur during pregnancy, at the time of delivery, or during breast feeding. 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 a short course of antiretroviral drugs significantly reduces the risk of HIV transmission. In 2007, an estimated 34% of pregnant women living with HIV in low and middle income countries received antiretroviral regimens to prevent transmission of the virus to their infants.

HIV-infected mothers 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 infectious diseases such as diarrhoea and respiratory infections. Click on the link above to read more about HIV and infant feeding.

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. 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. As of December 2007, about 198,000 children globally were receiving antiretroviral therapy, up from 127,300 children in 2006 and 75,000 in 2005. Many HIV-infected children also suffer from undernutrition.

UNICEF’s response

Fighting HIV/AIDS is one of UNICEF's five organizational priorities over the next four years. Nutrition programming in the context of PMTCT 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”.