Microsoft word - kids without arvs.doc

This programme is about caring for children who do not need, or cannot yet
access ARVs.
Many children live for a long time without needing ARV treatment.
- Each year in South Africa:
• Another 26 000 are infected by breastfeeding. • That's a total of 63 000 new infections each year. - Of every 100 children born with HIV, who do not receive antiretroviral
• 30 will die before they are one-years old, • another 20-30 will die before they are four, • and another 30 will die before they are nine. - In any year, there will be about 244 000 children living with HIV, most of whom will die without access to ARV therapy.
Children are very vulnerable to HIV. Of every 100 children who are born HIV
positive and don’t receive ARV treatment:
• the rest will die slowly over the next few years, • and most will be dead by the age of 12. - Fortunately, ARVs can greatly prolong the lives of children living with HIV. - Our government is now supplying ARVs to people through public clinics. However, there are still kids who cannot get access to ARVs. Sometimes it’s because they are not yet eligible to take ARVs. - ARVs MUST be made available to all children living with HIV who need them.

Kids Without ARVs
Page 1 of 4
CHMT, 2006
Discussion points:
- How many children are born with HIV in South Africa each year? - How many babies are infected through breastfeeding? - Out of 100 kids with HIV who are not on ARVs, how many will die before

There are many different things that we can do to take care of children who are
HIV positive:
Early and Effective Treatment
- If the child starts to get sick, we can make sure they get early and effective treatment for any infection. Every opportunistic infection can weaken the child's immune system and make AIDS develop faster. This is why early and effective treatment is so important. - Using Bactrim or Cotrimoxazole can protect the child against infections like PCP pneumonia, diarrhoea and toxoplasmosis. - Early and effective treatment needs a responsible caregiver. • - The child should eat healthy food and get all the necessary vitamins. These will
make him grow like he should.

- A child needs to be immunised at the clinic against infections.

Monitor the Child’s Growth
- A child's weight must also be recorded. Is the child growing, getting enough
food and gaining weight?

Preventing Infections Using Cotrimoxazole (Bactrim)
- Bactrim will protect the HIV positive child from opportunistic infections. It's important that the mother be given Bactrim and uses it at all times. Listen To Your Child
- Some kids will tell you when they have a problem or are experiencing pain but others will not. It is important to ask your child how they are feeling. - Take the child to the doctor or to the clinic and find out more about the pains they are experiencing. This is especially important when dealing with HIV positive children. Kids Without ARVs Page 2 of 4 CHMT, 2006 CHAPTER THREE: ORAL HYGIENE
- Good oral hygiene helps prevent the child developing oral thrush (thrush of the mouth) or candidiasis, which is a fungal infection. Thrush makes eating very difficult, which will stunt the child’s growth. If oral thrush becomes worse, it will spread down the food pipe, when it is called oesophageal thrush. - Thrush of the food pipe, or oesophagus, is very serious. It is a Stage Four illness, which means the child has AIDS and needs to start antiretrovirals immediately. - If the child does develop thrush, it will be treated with Nystatin liquid. If the child develops thrush of the food pipe, or oesophagus, it should be treated with liquid
fluconazole, which the child must swallow.


- When a child is HIV positive, it is even more important that we prevent bacterial
infections. How do we do this? We must:
• always wash our hands when preparing food, • make sure that fresh foods, such as fruit, are very clean, • make sure that children’s hands are clean when they eat. This can prevent diarrhoea.
- The fungus that causes cryptococcal meningitis is found in household dust. We
must therefore keep the child's environment as clean as possible.
- Another dangerous opportunistic infection is called toxoplasmosis (toxo). Toxo
is spread in the faeces of cats and in bird droppings. So it is best to keep an
HIV positive child well away from cats and birds.
- If we live in areas where there are no proper services, with no clean water or
sewerage, such as informal settlements, it is difficult for children to avoid getting
worms. If children have worms, it can wear down their immune systems very
quickly. But treatment for worms is easy and cheap. Take your child to a health
care worker for de-worming every six months.
Discussion points:
- What fungus is found in household dust? - What infection can we get from cat or bird faeces? - What makes children more likely to have worms? Kids Without ARVs Page 3 of 4 CHMT, 2006

In this programme, we've learned how to take care of children who are HIV positive and who don't have access to ARVs. The hard truth is that many of these children will not survive no matter how well we take care of them. But caring well for HIV positive children will definitely give many more of them a chance to live happily. We need to ensure that all children with HIV who need them have access to ARVs can receive them. Kids Without ARVs Page 4 of 4 CHMT, 2006


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