Pediatric HIV/AIDS in the United States

Over the past 30 years, pediatric HIV/AIDS cases in the U.S. have declined dramatically; however, this remains a very vulnerable – though often forgotten– piece of the U.S. epidemic.

From the onset of the epidemic in the late 1970s through 1994, there were an estimated 14,920 perinatally HIV-infected infants born in the U.S.  New infections peaked in 1992, with around 2,000 new cases a year. But those numbers began to drop dramatically with important research that discovered a way to prevent infections between pregnant mother and child. Since this breakthrough, the number of HIV-infected infants has remained steady at less than 200 new infant infections per year.

The small number of new HIV infections from perinatal transmission demonstrates the importance of reaching HIV-positive pregnant women with these services. It is estimated that there are approximately 8,500 HIV-positive pregnancies in the United States each year, but less than 150 new infant HIV infections – a testament the effectiveness of U.S. prevention efforts.  But there is still much to be done if we want to eliminate all new pediatric HIV infections in the United States and keep children living with HIV happy and healthy.

We must stay vigilant. If we turn an eye from HIV-positive pregnant women, the number of pediatric infections number could easily spike. HIV-positive pregnant women have many services available to them in order to prevent perinatal transmission of HIV, but without identification and linkages to treatment, these services are useless. Women represent over a quarter of the U.S. HIV epidemic, yet high-profile activities, such as the National HIV/AIDS Strategy, all but ignore the unique prevention, treatment and support needs of this population.

We can get the number of pediatric infections closer to zero. Based on the most recent study from the Centers for Disease Control and Prevention’s through their Enhanced Perinatal Surveillance System, we know that testing is one of the key areas of focus for investigators looking to see where the gaps remain for HIV-positive women and their infants.  Thirty-two percent of women were not diagnosed with HIV until some point during pregnancy, including 3 percent at labor and delivery. Additionally, 15 percent did not get the medicines they needed to prevent transmission to their children. Addressing these systemic cracks is critical.

We must support programs and policies that address the unique needs of children living with HIV.  Lastly, 100 to 200 children born HIV-positive each year, combined with foreign-born HIV positive children moving to the U.S., add up to a significant numbers of children living with HIV in the U.S. healthcare system. We need to ensure that they have access to effective treatment and care services, administered in family-friendly settings, with the best medicines formulated specifically for their needs. Children with HIV, like many other children with “adult” diseases, are often left behind in the drug and device development process, forcing their doctors and caregivers to piece together treatment options for them.  We can do better.

We have made incredible strides against pediatric HIV/AIDS in the U.S., but there are still more opportunities to lessen the impact of this disease on children.

 

*All statistics come from the Centers for Disease Control and Prevention