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Many Challenges Exist To Delivering Proven Interventions For Preventing Pediatric HIV Infections

Last week’s “scientific report on the ‘functional cure’ of an HIV-infected infant has set the world’s media ablaze with discussion and speculation,” Randal Kuhn, director of the Global Health Affairs Program at the University of Denver’s Josef Korbel School of International Studies, and Benjamin Young, chief medical officer of the International Association of Providers of AIDS Care, write in a GlobalPost opinion piece. “While we wait for scientific confirmation of the treatment, this little girl’s case crystallizes the continued challenges of delivering interventions already proven to prevent pediatric HIV/AIDS,” they continue. “Of the four million children born each year in the United States, just 100 are born with HIV/AIDS,” they write, adding, “This impressively low number is thanks to a combination of widespread antenatal care, regular HIV/AIDS testing of high-risk mothers, and pharmacological advances in combination therapies for preventing mother-to-child transmission (PMTCT) in utero, before the virus has a chance to take hold in the fetal immune system.”

“Although this package of interventions is incredibly low-cost, about 330,000 babies will be born with HIV/AIDS in less developed countries, primarily in sub-Saharan Africa,” Kuhn and Young continue, adding, “This is due to stigma and discrimination, but most of all due to the lack of resources for these interventions.” “[T]he costs of standard three-drug treatments for children infected with HIV can be out of reach in many countries,” they note, adding, “At the same time, in many populations non-adherence is accompanied by malnutrition, exposure to other infectious diseases, and poverty, all factors that may make the pathway to recovery quite different.” They state, “These issues won’t be solved with new medicines, but rather a critical reassessment of community beliefs about HIV/AIDS and some deeply held prejudices,” and conclude, “[T]he promise of curing the 300,000 babies born with HIV each year cannot be achieved unless babies are delivered in a health care facility with the necessary funds, diagnostic tools, medications and well-trained health care providers” (3/10).