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Programmes to prevent HIV/AIDS
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Some two million HIV positive women become pregnant every year. In 1999, an estimated 600,000 children aged 14 or younger became infected with HIV bringing the number of children living with the human immunodeficiency virus which causes AIDS to 1.2 million. Of these, almost nine-tenths were in sub-Saharan Africa. Approximately 90 per cent of infants and children with HIV have become infected through mother to child transmission (MTCT) during late pregnancy, labour, childbirth or breastfeeding.

In the absence of preventive measures, the risk of a baby acquiring the virus from an infected mother ranges from 15-25 per cent in industrialised countries and 25-35 per cent or higher in developing countries. Infants in Eastern and Southern Africa are particularly at risk as a consequence of high fertility rates and high infection rates among women of childbearing age. Some five per cent of HIV-exposed children are infected during pregnancy; about 15 per cent are infected at delivery; and approximately 10 per cent are infected through breastfeeding. The mechanisms of transmission of HIV from mother to child include transplacental infection, microtransfusion, ascending infection through the vagina, or direct contact by the infant.

The sources of infection include maternal blood, placenta, amniotic fluid, cervicovaginal secretions, and breastmilk. The routes of entry vary from umbilical circulation, skin, and mucous membranes including gastrointestinal tract and respiratory tract. Data from several countries has shown that the number of children infected by the disease can be considerably reduced with concerted effort to prevent mother to child transmission of HIV/AIDS. Cost effective interventions exist and can be tailored to specific local situations to prevent mother to child transmission of HIV and to reduce the mortality rates of children under five. Additionally, strategies and interventions to prevent mother to child transmission of HIV are an important means to strengthen health systems, reduce the impact of AIDS, and mobilise societies to combat HIV/AIDS. Deaths due to HIV/AIDS are eclipsing the gains which have been made in the improvement of child health and nutrition and the reduction of the number of deaths from tetanus, measles, diarrhoea and pneumonia. HIV/AIDS, in fact, precipitates or exacerbates malnutrition, diarrhoea and pneumonia. In view of UNICEF's involvement with mother and child health and nutrition, as well as its global role in the promotion, protection and support of breastfeeding, prevention of mother to child transmission (PMTCT) has become a priority programme area for the organisation.