In Latin America and the Caribbean, over 55,000 children under 15 lived with the virus last year. The Caribbean is the region with the second highest prevalence of HIV in the world, after Sub-Saharan Africa (1%, with an estimated 250,000 people infected).

These are some of the conclusions of the article Children and HIV/AIDS in Latin America and the Caribbean, by the HIV/AIDS specialists from UNICEF and PAHO/WHO, Vivian López and Mónica Alonso, published in the newsletter Challenges (Number 7, July 2008). Challenges is a periodic publication that analyzes progress towards the Millennium Development Goals from a child rights perspective, and is edited by the Economic Commission for Latin America and the Caribbean (ECLAC) and UNICEF's Regional Office for Latin America and the Caribbean.

The authors assert that lack of prevention in the vertical transmission of HIV -from mother to child- increases the number of babies born with the disease, and is a major cause of morbidity and mortality among small children, especially in developing countries.

Regionally, the vast majority of children with HIV were infected through mother-to-child transmission, when a pregnant HIV-positive woman passes the virus on to her baby during pregnancy, labour, delivery, or through breastfeeding.  Children may also acquire the virus through contaminated blood transfusion, blood products, needles and syringes, as well as through sexual abuse.

In the absence of any intervention, the risk of mother-to-child-transmission of HIV is approximately 15-30% if the mother does not breastfeed the child. This risk can rise to as high as 30-45% with prolonged breastfeeding, say the authors. However, the risk of transmission can be reduced to less than 2% with simple, inexpensive and effective interventions, they add.

Although the region has seen great advances in the expansion of care and treatment for adults, children continue to fall behind, even though HIV progresses more rapidly and aggressively in children than in adults. In Latin America and the Caribbean, progress in the prevention and diagnosis of the disease in children remains unsatisfactory, in spite of the existence of adequate means to mitigate the pandemic.

Countries in the region have adopted international agreements such as the Declaration of Commitment on HIV/AIDS (2001) and the Health Agenda for the Americas: 2008-2017, providing opportunities to save children's lives, reduce the impact of HIV in families and communities, and strengthen maternal-infant health care.

The researchers state that it is possible to scale up treatment for children infected with HIV in developing countries. To increase early diagnosis programmes, countries should allocate resources to ensure ample availability of viral testing, thus improving long-term survival of infected children.

HIV counseling and support for children, their parents and family is also essential and can considerably improve children's quality of life. A multidisciplinary approach should be employed as a means to ensure support from the community, social workers and counselors.

Governments should also eliminate barriers imposed through pricing, tariffs and trade, regulatory policy, and research and development, so as to accelerate access to affordable, quality HIV medicines and diagnostics.