World AIDS Day – children and young people lives transformed

World AIDS Day has become a well established global event marked with many different types of fundraising; awareness-raising and memorial events around the UK, Europe and the World. World AIDS Day does not tend to focus specifically on children and young people, or children and young people in care who, according to a recent report by Imperial College London, are still a much hidden minority within the overall picture of HIV/AIDS globally.

On top of this, children and young people in care affected by HIV ( either they themselves have the infection or their parents do) is even more than ever a small population whose needs are either marginalised, ignored or just so shrouded in stigma and mystery that they have now become invisible. If we consider the difference advances in medicine have made to those with HIV then we see how far the world has been transformed.  HIV/AIDS was first identified as a phenomenon in 1981 in California.  Its development was well publicised and has become well established in everyone’s social history.

Were an adult to be diagnosed with HIV infection in 1985 then even with the best of medical care and most positive of health situation’s, average life expectancy from diagnosis to death was eighteen months.  As well as this, anyone diagnosed with HIV/AIDS faced the social consequences – discrimination, isolation, and fear. Nowadays the picture is very different – through the discovery of triple combination therapy medication in 1996, and the determination to focus on HIV patients as people with specific needs, nearly everyone diagnosed nowadays will enjoy full health and full life expectancy – even more amazingly anyone diagnosed nowadays is highly unlikely to die in old age from  an HIV-related illness.  Most likely it will be the same illnesses and conditions that cause most people’ deaths – heart disease, cancer and old age.

In 1993 deaths from HIV peaked at over 1600 per annum.  In 2012 that figure stood at 300, and has not risen at all despite a significant rise in the number of people living with HIV. And what about children and young people ? In 2012 Imperial College estimated that there now around 1200 children and young people living in the UK with HIV.  This is far below the peak number in the late 1980s.  The reasons for the much lower number are straight – forward.  Ante-natal care of pregnant mothers has improved significantly with universal routine HIV and Hep C testing.  Medication can be prescribed to mothers testing HIV positive which lowers the risk of HIV transmission to more manageable rates.

HIV care of pregnant mothers is now very advanced, and most HIV positive mothers have a normal vaginal delivery. Overall, thankfully mother to child transmissions of HIV to children born in the UK are very low.  Many children with HIV were affected after birth, or were born outside of the UK without the excellent medical care offered by the NHS. And what about children and young people in care affected by HIV on World AIDS Day ? Numbers of children in care with HIV are relatively low, less than 150.

The numbers of children in care thought to be affected by someone else’s HIV is high – nearer 1000.  Despite the advances in HIV care, we have seen the profile of HIV diminish rapidly over the past decade.  Safer sex messages and HIV as an explicit element of sex education is also at an all time low (Terence Higgins Trust).

Children and young people now are bombarded with sexual messages in the media and on the Internet, so maybe whilst the advances in HIV care and life expectancy should be celebrated, the fact that HIV infection re climbing steeply, and the profile of HIV has called through the floor should be treated with much concern, and demonstrate that there is still a long way to go. So it would seem a mixed picture.

Young people, if diagnosed as HIV positive can experience good medical care, good health prospects, tough anti-discrimination laws and full life expectancy.  So once diagnosed it would seem the picture is as positive as it can be.  However , in a recent survey the National AIDS Trust identified that HIV diagnoses across the UK are climbing at their fastest rate for many years! with nearly 100 000 people in the UK living with HIV.

So the challenge for the near future is promoting effective sexual health messages and managing young people’s sexual health and development in a way which minimises the risk of HIV transmission. World AIDS Day is perhaps about saying that the world is on a journey, in a positive progressive direction, but with many things still needed to be done.

Source :  BBC News