Paediatric HIV disclosure in South Africa - caregivers' perspectives on discussing HIV with infected children

Most paediatric HIV infections in South Africa are transmitted perinatally. Lack of widely available HIV treatment means that most children do not survive to an age at which disclosure becomes a relevant concern. However, with the expansion of HIV treatment programmes the proportion of HIV-infected children surviving to an advanced age is likely to increase substantially during the next 5 - 10 years. A similar phenomenon was observed in Europe and North America with the advent of antiretroviral therapy (ART) in the mid-1990s, and in resource-rich settings approximately half of perinatally infected children are expected to survive beyond 13 years of age.

Exploring current practices in pediatric ARV rollout and integration with early childhood programs in South Africa: A rapid situation analysis

This Horizons program report describes the status of pediatric HIV treatment in selected sites in South Africa, identifies gaps in service delivery, and proposes recommendations for strengthening services and expanding children’s access to treatment. The study provides much needed information on critical issues of pediatric HIV care, especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children, and key factors that facilitate sustainability of treatment by young children. The aims of the study were to identify successful program strategies in pediatric HIV treatment in South Africa and to determine priority knowledge gaps to be addressed by operations research. The demonstrated model of collaboration between government and NGOs, though not an easy relationship to manage, can be very successful at scaling up and ensuring sustainability

Expanding pediatric access to antiretroviral therapy in South Africa

In sub-Saharan Africa, AIDS has become one of the leading causes of death among children under the age of five years. Yet, despite increased availability of antiretroviral therapy (ART), children have been largely ignored or excluded from treatment initiatives. While efforts to get more children on treatment are increasing, important information is lacking to guide program and policy implementation. To address these gaps, the Horizons Program and the University of Cape Town conducted a rapid situational analysis in 2005 of pediatric HIV treatment sites in South Africa. In 2003, the South African government approved a plan for a national HIV treatment program with the goal of at least one service delivery point in each district providing treatment. The government guidelines emphasized providing treatment for both adults and children and the initial effort resulted in a significant number of children initiating treatment. This research summary details what is happening on the ground to understand how children have been affected by the ART rollout and what can be done to reach the thousands more that should be on treatment