This paper will focus on the problems connected with children and HIV. HIV and AIDS are severe illnesses of the last and this century, and the worst fact is that children also suffer from them. It is commonly considered that AIDS is a kind of disease that can kill adult people. But there is a great number of problems connected with children with AIDS or orphans, whose parents died because of this terrible disease and so on. As this virus usually is transmitted through sexual relations or drugs usage rarely is it associated with children affection. But in reality, millions of children all over the world live with HIV.
We will stop now a little at the term “HIV positive,” it means that a person was infected with HIV and there are antibodies or markers for HIV in his blood, in other words, hi is “positive” for antidotes. The main aim of the immune system in the body of a person is to fight with bacteria and viruses and the immune system produces antibodies. But although the immune system can produce the antibodies for HIV it is not enough to kill the virus. HIV means Human Immunodeficiency Virus. This virus is the cause of AIDS (Acquired Immune Deficiency Syndrome).
The statistical research shows that about 3.1 million people die every year in the whole world and among them about half a million are children below 15. By the end of 2005, about 2.3 million children were living with HIV, taking into consideration that exact figures might be higher at some less-developed countries as they do not have enough facilities to provide the calculation of exact numbers. To accept the death is rather difficult for an adult person and children this is a tragedy as most of them are not even aware of the cause of their coming death.
According to international laws, a child is a person under 18 years old. Most of AIDS organizations consider children to be below the age of 15. Thus we can not rely upon the facts concerning the number of ill children as sometimes the children from 15 to 18 are not counted. By the year 2005, about 700 000 children were infected with HIV, and about 80 % of them were from sub-Saharan Africa, Asia, the Caribbean. Most of the children were infected by their mothers during pregnancy or breastfeeding.
According to the researchers, more than a quarter of children who are born with HIV live no longer than a year, about 60 % die before they become two years old. In some countries where the incomes of people are higher, the number of transmissions of HIV from mothers to children is lower as there is usually a great range of medications and they allow children live till adulthood. It is clear that with enough funding and staff and resources the high rates of deaths of children infected with HIV in lower-developed countries could be avoided.
There are several ways how children are affected by HIV. First of all, there are a lot of children who are HIV+ themselves. Other children have to live with their family members who are HIV +, children are to take care of their parents who have AIDS; children become orphans when they lose one of both parents who had AIDS; children have to become the heads of the families as sometimes they also have to care for their younger sisters and brothers; very often children have to work and earn money in order to pay for expensive medications.
In the community they live in, children also suffer from discriminations, lose their close people due to AIDS, as doctors and nurses die as well there appears the lack of medical care for children who need it.
One of the main ways the child gets infected is – mother-to-child transmission. It is not always so that children get infected in the womb during their mothers are pregnant, but such cases are not rare. Even if they were not infected in the womb, they contact the fluids of their mother during the birth process and can become infected this way as well. Later on when a mother starts breastfeeding appears another danger of infection.
There are some cases when although the mother is not infected, her child is, this happens in the medical setting where children contact with infected blood products or not sterilized needles or some other medical equipment. In some wealthy countries the doctors do their best to avoid such situations, but in some less-developed countries, the risk is rather high. The bright example could be the situation in Romania. Between the years 1987 and 1991, about 10 000 babies and small children were infected after contaminated injections and unscreened blood transfusions.
It was already said that such ways of infection as drug usage and sexual activity are more associated with adults, but in fact, they are the same risk situations for children who come closer to the age of 15-16. The factual age of children who start their sexual life does not correspond with the age when it is considered to be appropriate. Young people are also inclined to using drugs. In undeveloped and as well in developed countries, not all children receive enough sexual education. The reasons are different, either moral or religious beliefs, cultural reasons or lack of resources. Some children start their sexual life or start taking drugs not being even informed about the risk they are taking. They often do not know about the ways of protecting themselves from infection and other unpleasant consequences. There are some situations when children are raped or become victims of sexual abuse, and as a result, are infected, in case the abuser was HIV+. Children suffer in this case not only from psychological trauma but the illness as well. Not in all countries enough attention is paid to this issue, on the contrary in South Africa, for example, exists a myth that a virgin can cure a man with HIV – as a result, men with HIV+ rape children, sometimes really young ones. In some developing countries, where children have to look for food and protection, sex for money brings HIV infection to them.
Children have almost the same illnesses like mumps, measles, chickenpox, but for children who are not HIV+ these diseases are not of great risk, children HIV+ usually have to suffer longer from these illnesses and hardly react on the usual treatment means. As children have a really low level of their immune system is it not possible to give them the general vaccines, generally recommended for children. In children, HIV progresses into AIDS much sooner as in adults if children are without necessary treatment. They are at a high risk of dying during their first years.
Besides, it is more important for children to have a better trained medical staff than it is for adult people. But in some countries like Africa for example, children are to be happy if they have any medical care. It is not allowed to use the less quantity of the same drugs that are used for adults, but this is the only way out for some less-developed countries. The doctors have just to break the pills into smaller pieces never knowing for sure that the child got the necessary dose of the medicine. In some occasions, children are given the same doses of the drugs as adults.
As it was already mentioned, it is quite possible to avoid the transmission of HIV from mother to a child in case of appropriate intervention.
The main methods are as follows:
- helping women to prevent HIV infection
- helping women to prevent pregnancy in case they are HIV+
- special test procedures for women to identify whether they are HIV+
- Women with HIV+ are at a greater risk of passing the virus to their children if their viral load is high. There are ways of lowering her viral load through special good treatment. Thus the chances for her baby not to be infected are higher.
- If it is not possible to give the mother the necessary treatment she and her child are offered a dose of nevirapine, before or after birth.
This is the worst treatment option, but in some areas, this is the only one.
- An HIV+ pregnant woman might choose a cesarean section birth – surgical interference. The negative moment about this choice is the part of risk as well as in any other surgical procedure.
- If a baby is born and not infected from his HIV+ mother, it is possible to use artificial milk to avoid infection during breastfeeding.
All these methods were for preventing the infection of newborn children, but all children need our attention. Even taking into account all legal means to keep children from using drugs or becoming sexually active too early, it is clear that it is not possible to provide 100% control and there always will be children who will break this laws and rules. At any rate children and youngsters should receive appropriate sexual health and HIV/AIDS education for them to make a more conscious choice about starting to get sex experience or drugs usage. Children should be taught how to avoid all possible dangers and risks connected with drugs; they should know the ways of protecting themselves and should be made aware of the places or special centers where they can get the support of help in case they need it, without judging them.
There is a great number of treatment procedures that are to be used for children who are HIV+ or were born from HIV+ mothers. There is a common way of testing to check the antibodies of the virus. Every baby born from HIV+ mother is supposed to have them in his body. Then the test gives the positive result even if the baby is not infected. The results of such test are useless for the first 18 months of baby’s life. If the more complicated medical equipment is available another test could be done – viral load test. It also identifies HIV in a baby.
Concerning the treatment procedures of children, it is a necessity to mention that the first part of treatment is monitoring the children to look after their health. The viral load tests and CD4 cell-counts cannot provide exact results for children as their immune system is not enough developed. According to doctors children are to receive fewer drugs during their treatment course.
Children with HIV+ are at a risk of opportunistic infections – these are the infections that cause death. The typical example of such infection is PCP (this is a type of pneumonia), usually is met by very young children.
It often happens so that a child who is HIV+ has another family member who is infected and thus this child could suffer from financial hardships as well. The emotional suffering in such families comes after losing a parent or close relative who had AIDS. If the child is HIV + or just has HIV, he needs a great portion of emotional support and care from the community.
Children with HIV or AIDS very often experience discrimination in the community; they have to take care of their families, often have to leave school, and earn money for the family. Some children are left to their relatives, uncles or grandparents in cases of death of both parents, but sometimes they stay utterly alone and even have to take care of their younger sisters and brothers, such families are called – child-headed households, such children, are vulnerable to exploitation and HIV infection as well. Some people do their best to help such children either with food or clothes.
Some health problems can be the results of HIV:
- HIV encephalopathy – HIV crosses the brain. Usually, the parts of the brain responsible for child’s talking and moving are affected. Such children have problems with a stiffness of the arms or legs, have problems with coordination. Children can not learn new words or experiences difficulties in talking process. The normal speed of development is not possible anymore, children sometimes even lose skills they have already gained before.
- Recurrent bacterial infections like ear infections, blood infections, meningitis are quite common. Children who do not have HIV are also vulnerable to such infections, but if the child has these infections for many times, this is the bad sign that the immune system of a child is ruined.
- Problems with gaining weight or not growing are also common for children with HIV. Children lose appetite because of drug treatment often. Diarrhea and other gastrointestinal complications are also the results of HIV.
It is natural that parents of infected children are worried about infecting others. They should be informed that people do not catch this virus just living in the same house or using the same school or playground. Pets and insects do not pass the virus either.
The usual hygiene means are to be used with children with HIV; the only extra care should be taken about blood. It is necessary to put on gloves when dealing blood. In case the child was cut somewhere a bandage should be put for 24 hours. If some splashes of blood got on somebody’s face or skin, it is necessary to wash them away as soon as possible. The towel which was used while washing should be put into a plastic bag and thrown away. Dishes and other utensils can be washed the usual way since the virus is not transmitted this way. Parents of children with HIV should also pay attention to giving children their medicines.
Other important questions that parents of children with HIV face are the question whom to tell about the virus in the family. Such decisions are very private and should be taken only by parents themselves; it is only very important to inform health staff working with such children, like nurses and social workers, dentists and other family doctors. Some serious infections can start in the mouth, that’s why it is important to make the regular visits to the dentist.
Parents should also remember that a child infected by this virus suffers not only physically but emotionally as well, because of intimidation by doctors, because of feeling lonely if the child is taken to hospital from his family, if one of the parents dies because of AIDS, because of possible side effects of medicines. Although too young, children might experience the fear of disability or even death. In such cases, parents need the help of professionals, doctors, social workers, sometimes even the pieces of advice from other parents whose children are infected.
Overall, AIDS and HIV are tremendous and global problems of people all over the world. Millions of people suffer from them, and the most terrible fact is that some part of them is children. In this paper, we considered some basic notions connected with this virus, studied the research dealing this problem, learned about the crucial issues that should be taken into consideration by people taking care of children with HIV and so on.
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