Prevention of Parent-to-Child Transmission of HIV: Clinical Guidelines
According to United Nations Year 2006 estimates, there are 2.3 million children living with HIV and/or AIDS in the world today. The vast majority of these children are living in Asia and southern Africa. Mother to child transmission during pregnancy, child-birth, or through breast-feeding is the most common source of infection in children.
HIV and AIDS has not spared Pakistan and an increasing number of women and children infected with HIV are being reported from around the country. Although the documented number of peri-natally acquired cases among children in Pakistan is still low, several factors contribute to suggest that this number is significantly under-estimated. These include the lack of awareness about HIV and AIDS among the general population and among health care professionals, the stigma associated with HIV and AIDS, lack of diagnostic testing facilities and the difficulties of making a diagnosis in children, especially in a country where malnutrition rates are as high as 30 per cent among children under 5 years of age.
To date, the majority of HIV-infected children identified in Pakistan have been born to mothers whose husbands’ acquired HIV while working abroad and were identified through routine screening for visa processing/renewals. As national screening programs for voluntary counseling and testing for HIV develop in Pakistan, it is expected that more HIV-infected individuals, including women in reproductive ages from all cornors of the population will be identified. Additionally, recent epidemiologic evidence from the National AIDS Control Program (NACP) and the provincial programs indicate that Pakistan is facing a concentrated epidemic (>5% sero-prevalence) in any sub-population among male sex workers and intravenous drug users (IDUs) in several urban locations throughout the country, with rates as high as 26 per cent in IDUs in Karachi.
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