South Africa’s HIV success story

Amy Slogrove, Kathleen M Powis and Mary-Ann Davies

One of the most remarkable public health successes of the last decade in southern Africa has been the reduction in the number of babies born with HIV.

This was achieved through the provision of antiretroviral therapy to pregnant and breastfeeding women living with HIV, contributing to a decrease in new HIV infections in children in South Africa from a peak of 70 000 in 2003 to 13 000 in 2017.

Nevertheless, worldwide there are still an estimated 14.8 million children under the age of 15 who were born HIV-uninfected but have been exposed to their mother’s HIV during pregnancy.

The largest number of HIV-exposed but uninfected children – 3.2 million – are in South Africa.

A staggering 30% of pregnant women in South Africa have HIV. Their infants are exposed to both HIV and antiretroviral drugs during pregnancy and breastfeeding.

This is a big deal because HIV-uninfected children born to mothers with HIV are prone to infections that are more severe, are at almost two times greater risk of dying before their first birthday and are more likely to be born prematurely than children born to mothers without HIV.

Children born to mothers with HIV make up almost one in every four infants in Botswana and South Africa and because they die more often than children born to mothers without HIV – even when they are HIV-uninfected themselves – this contributed to a higher infant mortality rate in both countries.

Uninfected children born to women with HIV experience a complex package of detrimental exposures.

HIV-exposed but uninfected infants are still more often born preterm or of low birth weight. This increases their risk for complications and death early in life.

Republished from Theconversation.com