Impact of HIV on the Health of Women and Children: Focus on Africa

                   Impact of HIV on the Health of Women and Children: Case study Africa

Introduction

Since the beginning of the global HIV epidemic,  the demographic that is most at risk has been women  and children. Women make up more than half of the global population living with HIV while every day it is estimated that 1,000 children are infected with HIV, especially in third world countries.  Bettinger and his colleagues capture the impact of the AIDS virus on women and children very comprehensibly in their research “Pattern of infectious morbidity in HIV-exposed uninfected infants and children” which serve as a guide to this paper. Basically, knowing impacts of HIV on the Health of Women and Children can serve as a good way of understanding where we are on a global scale and what we ought to do better to safeguard the future of humanity.

Basic Facts about HIV and AIDS

AIDS (acquired immunodeficiency syndrome) is a syndrome that is caused by a virus called HIV (human immunodeficiency virus).It is an infectious disease which alters the immune system, hence making the infected individual to be much more vulnerable to other infections and diseases. It is because of this susceptibility that the disease worsens given that the syndrome progresses (Pau et al, 2009). HIV can be found all through the body tissues but is transmitted through the body fluids of a carrier (an infected person) through semen and vaginal fluids hence why it is an STI i.e sexually transmitted infectious disease. Can also be passed on through blood, and breast milk (Pau et al, 2009).

AIDS is a disease that caries HIV a virus that targets and attacks CD-4 cells which are our bodies’ immune cells. AIDS is the advanced stage of the syndrome, upon HIV infection. Basically HIV is a virus while AIDS is a medical condition. Being infected by HIV can cause the development of AIDS. However, there is a possibility of contracting HIV without having to develop AIDS. However without treatment, HIV may progress eventually developing into a full blown AIDS. This is why there are very rare cases of children having the full blown AIDS disease and due to the medical interventions and treatments also few women have AIDS. This is a disease that is common among sexually active individual regardless of age and gender however it has had a more profound effect on women and children as they bear the greatest risk and impact.



Trends in HIV among Women and Children

In 1996, over 400,000 children below the age of 15 became infected with the virus (Bettinger et al, 2016).  According to global estimates by UNAIDS, a total of 2.6 million children had contracted HIV in 1996 with more than half succumbing to this virus. Also, one million children are living with the virus, most of whom living in sub-Saharan Africa while these numbers continue to increase rapidly in Asia, Latin America and the Caribbean. These trends continued such that by the year 200, about 10 million children had already contracted HIV with the majority being infected through mother-to-child transmission (Bettinger et al, 2016). It is also estimated that four in 10 HIV+ children die before reaching 1 year, with many surviving beyond two years, and some reaching adolescence (Bettinger et al, 2016). Based on this overview, we can get the scope of understanding the impact HIV has had on women and children.

Impact of HIV on the Health of Women

Today, AIDS-related illnesses are still the leading cause of death for child bearing women (ages 15-44). Young women in particular (ages 15-24), and girls upon entering puberty (ages 10-19) account for the highest prevalence of latest HIV infections (Cuca and Rose, 2016). For example in the year 2016, new HIV infection rates among child bearing women (ages 15-24 years) were 44% greater in comparison to their counterparts. In sub-Saharan Africa, child bearing women constitute 26% of the regions new HIV cases despite them accounting for only 10% of the region’s population (Cuca and Rose, 2016). It is also estimated that about 7,500 young women worldwide acquire HIV on a weekly basis. In Sub-Saharan Africa young women are said to acquire HIV on an average of five to seven years earlier in comparison to their male counterparts. In the year 2015, new weekly HIV infections averaged 4,500, doubling the same prevalence in young men (Cuca and Rose, 2016).

In the west and central African regions, HIV prevalence among the youths was 64% among young women in 2015. The disparity is more disturbing in countries like Cameroon, Ivory Coast and Guinea as girls in adolescent (ages 15–19) are up to five times more susceptible to HIV infection than their male counterparts (Cuca and Rose, 2016). European and Asian regions are not exempted from this disparity such as former soviet states in Eastern Europe and regions in Central Asia, whereby the most affected population is injection drug users majority of whom are men, but women constitute the rising proportion of HIV+ people. For example in Russia, the number of child bearing women (ages 15-24) who live with the virus doubles that their male counterparts. It is unfortunate that this epidemic remains a woman’s epidemic (Cuca and Rose, 2016).



Why Women are at Higher Risk of HIV

HIV disproportionately affects the female gender because of inequality in cultural, social as well as economic status in our society. Contributing factors based on these inequalities are intimate partner abuse, inequitable laws coupled with uncouth traditional practices which reinforce inequality between the two sexes (men and women), whereby women of child bearing age in particular are disadvantaged. Not only gender inequality can be attributed to driving HIV, but it is also responsible for entrenching this gender bias, leaving women to be more susceptible and vulnerable to its adverse impacts (Amin, 2015).

HIV Testing and Counselling (HTC) for Women

There is a big gap in HIV healthcare service for infected women evident in HIV testing as well as counselling (HTC), which bears the brunt of this prevalence because it is a crucial gateway to medical services (Amin, 2015). According to a study curried out in East Africa between the years 2003-2012 it found that for example in Tanzania, the odds of HIV testing were disproportionately higher among married women (ages 15-24) than single women (Cuca and Rose, 2016. The study also found that antenatal care was vital determinant for testing HIV. This study that took two years showed that women who had conceived within this time frame and were the receptors of antenatal care had higher probability of getting a HIV test in comparison to women yet to bear children.

Treating Women Living With HIV

It is not all doom and gloom when it comes to healthcare interventions such as Antiretroviral treatment (ART) as globally, women have more access to it than men. In 2016, women accounted for 60% of ART in comparison to men ate just 47% (Bettinger et al, 2016). The implication therefore is that despite women bearing the greatest HIV infection rate across the globe, their AIDS-related death rate stands at 27% lower than it is among men, a decrease of 33% from 2010 (Bettinger et al, 2016). In 2015, 9.2 million childbearing women (ages 15-44) living with HIV had access to life-saving ART with coverage being higher among expectant women attending clinics providing pre-maternal ART services. For example South Africa, while having ART coverage of barely 53% for childbearing women, pre-maternal ART coverage is over 95% same as Uganda (Bettinger et al, 2016).



Impact of HIV on the Health of Children

Logically speaking, since women are the bearers and caregivers of children, then it goes without saying that children are also disadvantaged when it comes to treatment and prevention of HIV. HIV and AIDS affect infants and children in the following three ways. Those with (Cuca and Rose, 2016):

  • HIV infection (such as mother to child transmission)
  • HIV affected (death or incapacitation of the caregiver)
  • vulnerable to HIV (through sexual abuse)

Children Suffering from HIV

The ways children can be infected with HIV is through mother-to-child transmission which is the most prevalent, contaminated blood transfusions due to malpractice by health care givers, unsterile medical equipment due to poor medical practice, or sexual abuse. According to estimates, a third of babies who are born to HIV+ mothers become infected (Chin, 1990). These children are most affected by the virus in settings with the highest prevalence of women affected by HIV.

Children who are carriers often have the same medical issues or conditions as children without HIV. During the initial stages, infected children often exhibit the same infections as those without HIV making diagnosis among this age group to be difficult. Like other infants, HIV+ children have common illnesses like diarrhoea, respiratory tract infections and malnutrition, but due to their high vulnerability to infection they get sick more often, is more serious and cumbersome to treat (Chin, 1990).That is why HIV infection significantly increases infant and child mortality rates. When the pandemic first struck, children were largely considered not to be at risk of contracting the virus. This misconception changed with time as it became clear that children (especially infants) infants had contracted the virus through medical malpractice such as contamination of blood transfusions and use of unsterilized medical equipment (Chin, 1990). It also became evident that an infected mother could be passed on the virus to her baby during pregnancy, at birth or while breastfeeding.



How HIV Affect Children

Globally, about 90% of infected children are thought to have acquired the virus through infected mother to child either during pregnancy, through birth or as a direct result of breastfeeding (Pau et al, 2009). When blood supplies are not properly screened for HIV, a child may be put at risk of being infected if transfused with contaminated blood (Pau et al, 2009).

A proportion of HIV+ children are infected through sexual abuse, though the extent of this is difficult to estimate especially for children under the age of five. Relatively, the importance of different modes of blood transmission varies from country to country depending on the quality of healthcare services, and the numbers of infected women.  However, there is a similar pattern in most parts of the world whereby the number of HIV infected children has a close relation to HIV infection in women (Bettinger et al, 2016). But not every HIV+ woman will pass on the virus to her infant. On average a third of children with HIV+ mothers will become infected.

HIV in Women and Children

Urban areas in developing countries have the highest prevalence for example in urban areas of East and Southern Africa, one third of pregnant women has the virus with transmission rates being higher compared to that in developed countries (Bettinger et al, 2016).



There are unclear cases whereby some babies of HIV+ women are infected while others are not. This remains part of the many unanswered questions with regards to when the infection gets transmitted from a mother to a child, and about the causing and/or contributing factors which may increase this risk of HIV transmission during pregnancy, at birth and while breastfeeding (Chin, 1990).  What is clear however is that HIV infected infants and young children in third world countries die at a younger age than those in first world countries. This may be due to the fact that they get more exposure to more infections, poorer healthcare services, and are likely to be malnourished. What is common across the globe is that many HIV cases in very young children do not get recognised or reported despite the virus being a major cause of health problems for this group of children (Chin, 1990).

Conclusion

The impact of HIV on the health of women and children is widespread being felt across the world mainly in developing countries. In sub-Saharan Africa, many children are left orphans due to the epidemic and although many organizations such as USAID, UNHCR, UNAIDS, WHO, etc have intervened with the help of local governments, the scourge is still being felt. There is a need for more emphasis on preventive measures and not curative measures to deal with this social vice such as empowering women and children through education and tough laws to curb inequality and abuse of women and children  (Chin, 1990). Although not a definitive measure, emphasis on this approach in tandem with the other measures already being undertaken such as treatment and prevention of mother to child incidences of transmission can go a long way in dealing with the impact of HIV on the health of women and children.

References

Amin, A. (2015). Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV. Journal of the International AIDS Society, 18, 20302.

Benson, C.A., Brooks, J.T., Holmes, K.K., Kaplan, J.E., Masur, H., & Pau A. (2009). Guidelines for prevention and treatment opportunistic infections in HIV-infected adults and adolescents; recommendations from CDC, the National Institute of Health and HIV Medicine Association/ Infectious Disease Society of America.

Cuca, Y. P., & Rose, C. D. (2016). Social stigma and childbearing for women living with HIV/AIDS. Qualitative health research, 26(11), 1508-1518.

Chin, J. (1990). Current and future dimensions of the HIV/AIDS pandemic in women and children. The Lancet, 336(8709), 221-224.

Slogrove, A. L., Goetghebuer, T., Cotton, M. F., Singer, J., & Bettinger, J. A. (2016). Pattern of infectious morbidity in HIV-exposed uninfected infants and children. Frontiers in immunology, 7, 164.

Assisting source

Clark, S., Bruce, J., & Dude, A. (2006). Protecting young women from HIV/AIDS: the case against child and adolescent marriage. International family planning perspectives, 79-88.

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