AIDS/HIV Information

AIDS is an acronym for Acquired Immunodeficiency Syndrome it causes a destruction of the immune system. It is the most advanced stage of the HIV virus (HIV stands for Human Immunodeficiency Virus). AIDS is defined by the Centers for Disease Control and Prevention (CDC) as the presence of a positive HIV antibody test and one or more of the illnesses known as opportunistic infections.

The HIV virus, type 1 or 2 is widely known to be the cause of AIDS. HIV breaks down and attacks your T cells so your body is unable to defend itself against different infections. The HIV virus also attacks your peripheral nervous system, this causes nerve and muscle pain, especially in the feet, legs, and hands.

HIV is spread through direct contact with semen or blood of an individual that is infected. This can be transferred in many ways the most common is unprotected sexual intercourse. Other means of infection are infected blood transfusions, mother to infant (at time of birth, or through breast milk), sharing needles with an infected person, and rarely a healthcare worker that gets pricked with an infected needle.

Often people who are infected with HIV have few symptoms and in some cases there are none. Other times, symptoms of HIV are confused with other illnesses such as the flu. This may be severe, with swollen glands in the neck and armpits, tiredness, fever and night sweats. This is where as much as 9 out of 10 of the infected individuals will develop AIDS. At this point the person may feel completely healthy and not even know that he/she has the virus. The next stage begins when the immune system starts to break down and the virus becomes more aggressive in damaging white cells. Several glands in the neck and armpits may swell and stay swollen for an extended period of time without any explanation. As this disease progresses boils or warts may spread over the body. They may also feel tremendously tired, night sweats, high fevers, chronic diarrhea, and they may lose a considerable amount of their body weight. Most cases have shown thrush as a symptom as well. At this point the person is in the final stages of HIV--AIDS. Severe chest infections with high fever are common and survival rate is above 70% but decrease with each recurrence.

A person is diagnosed with AIDS when he/she has one or more positive HIV screening and the presence of an AIDS defining condition. Some of the common conditions include but are not limited to: Meningitis, Encephalitis, Dementia, Pneumonia, Kaposi sarcoma, and Lymphoma. There is also a blood test called an Immune Profile that can be done. This test is used to measure the loss of immunity and help decide on the best treatment. There is a test that is rarely used due to its high cost, it is known as a Viral Load: This test detects the virus itself, and also measures the amount of HIV in the blood. It shows how quickly the HIV infection is likely to advance. A high viral load suggests that the person may progress rapidly to AIDS.

Although there is no cure for AIDS there are medical treatments that aide in prolonging, and maintaining the best quality of life possible. These include two nucleoside inhibitors, lamivudine and zidovudine. Actual treatment plans will vary with each patient, along with the physical aspect of this disease. The psychological side has to be addressed in order for a treatment plan to be effective.

The easiest way to escape contracting this disease is to avoid the risk factors that you are in control of. Such as: unprotected sex, not sharing a needle, and if you are in the healthcare field be sure to use all precautions necessary to avoid an accidental prick from a possible infected needle (remember that in this diseases early stages it is common for the person not to even know they are infected). Today AIDS is the fifth leading cause of death among all adults aged 25 to 44 in the United States. Among African-Americans in the 25 to 44 age group, AIDS is the leading cause of death for men and the second leading cause of death for women. Our society needs to become aware that by not protecting ourselves we are killing ourselves and that this has to stop.

CDC Recommends HIV Tests, Puts Less Stress on Condom Use

In a significant shift in strategy in the fight against HIV/AIDS, the Centers for Disease Control recently recommended that tests for HIV be extended to all patients entering hospitals and clinics in the U.S. The CDC also recommended that doctors begin offering routine voluntary HIV tests to patients between 13 and 64.

It is estimated that of the more than 1 million people in the U.S. with HIV and AIDS, about 25% are unaware they have HIV. The new strategy is aimed at discovering these cases before HIV develops into AIDS. It is also hoped these measures will curb the spread of the disease since these 250,000 people are carriers who unknowingly infect others.

This marks a departure from the previously followed strategy of testing only people in high risk categories.

This policy change will also involve a shift away from the promotion of abstinence and condom use to prevent the spread of the disease, towards more emphasis being placed on testing for HIV status and early treatment.

According to a spokesperson for the CDC, what explains this change in policy is that drugs now exist that can prevent the development of AIDS from HIV. Early detection can therefore result in early treatment. In the past early detection did not necessarily mean much since there was very little that could be done for someone infected with HIV.

It is also hoped that early detection will result in less transmission of the disease. A recent CDC survey found that sexually-active adults altered their sexual behavior patterns after they were diagnosed with HIV. They were less likely to engage in unprotected sexual activity, in many cases opting for a condom or for not engaging in sex at all.

Drug companies and makers of oral tests stand to benefit significantly from this change of emphasis. It is expected that tests which are now administered at hospitals and clinics will soon be available over the counter. People interested in testing themselves will be able to do it at home. This should result in a significant increase in sales of HIV testing kits.

There should also be a rise in HIV treatment drugs as hundreds of thousands of people learn they have HIV and begin treatment with anti-HIV drugs. Currently anti-HIV drugs account for about $6-billion in sales in the U.S. That number should increase dramatically if the new testing procedures prove to be effective.

Some argue that as in so many areas within the health industry, efforts aimed at prevention will be replaced by promises of a quick cure brought to us compliments of the incredibly influential and increasingly invasive drug companies.

Drugs For Treating Aids May Prevent People From Catching Aids

In one of the most promising developments in more than 20 years, scientists claim that drugs used to control HIV/AIDS in patients may also be effective in preventing the disease in the first place.

The drugs in question are tenofovir (Viread) and emtricitabine, or FTC (Emtriva), sold in combination as Truvada by Gilead Sciences Inc. Gilead is the California company best known for inventing Tamiflu.

Previous research has been aimed at finding a vaccine against HIV/AIDS, with the intention of conditioning the immune system against the disease. But these drugs work differently. They simply keep the virus from reproducing, and have already been used successfuly by health care workers to prevent them from being infected by the virus carried by patients.

This approach to fighting HIV/AIDS has been tempting researchers for many years, but has only recently become feasible as preventative drugs have been developed that are safe for non-infected persons to take. Previous drugs had unreasonable effects for uninfected persons.

That situation changed when Tenofovir came on the market in 2001. Tenofovir is powerful and safe, and it only has to be taken once a day. It also does not interact with other medicines or birth control pills, and manifests less drug resistance than other AIDS medications.

Monkey studies show exciting results

A major study by the CDC (Centers for Disease Control and Prevention) in Atlanta, Georgia involved six macaques. The monkeys were given a combination of Tenofovir and FTC and then administered a deadly combination of monkey and human AIDS viruses. They were given the viruses in rectal doses to simulate contact between gay men.

Each was given 14 weekly exposures of the virus, and none of the monkeys became infected. In a control group which did not receive the drugs, all but one got the disease, normally after just two exposures.

The scientists then stopped giving the drugs to the test group to see if the prevention was only temporary. The results were equally impressive. None of the monkeys contracted the disease. "We're now four months following the animals with no drug, no virus. They're uninfected and healthy," reported a CDC researcher.

Now other research teams are pushing to have this drug combination tested on humans. A $29 million CDC study of drug users in Botswana will now be switched to this new drug combination.

Another study of 400 heterosexual women in Ghana by the Family Health Initiative, and funded by the Bill and Melinda Gates Foundation, is studying the effects of tenofovir alone.

But several other studies have failed to materialize because studies of this nature immediately raise suspicions that scientists are using local people as guinea pigs. The fear is that they will intentionally expose the test subjects to the virus.

The cost of tenofovir and Truvada also make testing difficult. In African countries condoms are now liberally donated by companies, aid groups, UN agencies, and western governments. While the drugs are relatively cheap, the cost remains an impediment.

Nevertheless researchers have been reinvigorated by the stunning results out of Atlanta, and new tests are going ahead in pockets of interest around the worl

Acquired Immune Deficiency Syndrome: The Facts

Introduction

The first cases of acquired immune deficiency syndrome (AIDS) were reported in the U.S. in June of 1981. The occurrence of the syndrome among homosexual men, intravenous (IV) drug abusers and, later, blood transfusion recipients and persons with hemophilia suggested a transmissible agent as the cause. In 1984, scientists identified a retrovirus, human immune deficiency virus (HIV), also known as human T-Iymphotropic virus type III/lymphoadenopathy, associated virus (HTLV-III/LAV), as the primary cause of AIDS. In 1985, screening tests to detect antibodies to HIV were licensed, allowing identification of infected individuals and the screening of the blood supply. Researchers have been able to map the genetic structure of HIV and to demonstrate the nature of the immune defect. Ongoing research is aimed at identifying risk factors and preventive strategies, evaluating antiviral drugs, developing drugs to augment the immune system, and developing a vaccine.

An estimated 1,000,000 Americans have been infected by the HIV virus. The virus has been isolated from various bodily fluids including blood, semen, saliva, tears, urine, breast milk and cerebrospinal fluid. Transmission of HIV occurs primarily through four major routes: sexual contact, intravenous drug use, blood transfusions and perinatal contact with an infected mother. The screening of donated blood since 1985 for HIV antibodies has virtually eliminated blood transfusion as a risk for acquiring AIDS in the U.S. 95% of the cases of AIDS reported in the U.S. have belonged to the following high risk groups: homosexual and bisexual men, 73%; IV drug abusers, 17% (11% of homosexual and bisexual men also inject drugs); blood transfusion recipients, 2%; persons with blood clotting disorders or hemophilia, 1%; heterosexual contacts of persons in the above groups, 1%; and infants born to mothers with AIDS or HIV infection, 1%.

All persons with AIDS or with antibodies to HIV are considered carriers of the virus and capable of transmitting it to others. It is believed that most people with antibodies to HIV will remain free of AIDS symptoms. The ratio of persons infected with HIV to those with AIDS is estimated currently at between 100:1 to 50:1. The three-year incidence of AIDS among persons with the HIV infection ranges from 8% to 34.2% in selected municipal studies. Estimates are that 10% to 30% of infected persons will develop AIDS within 5 years. For persons who develop AIDS, the overall fatality rate in April of 1986 was 54%. At the end of two years following diagnosis of AIDS, however, the fatality rate was over 75%. At five years, the fatality rate was about 90%.

90% of AIDS patients are between 20-49 years of age. The loss of years of potential life before age 65 due to AIDS is nearly the same as for cancer in single men 25-44 years of age. The economic costs of AIDS are considerable, totalling an estimated $4.1 billion in 1985. Data cited here are changing rapidly and represent the situation only as of 1986.

Prevalence

Prevalence of HIV Infection

As of 1987, an estimated 1.5 million Americans were infected with the HIV virus.

In 1984-1985, the prevalence of the HIV antibody in populations of homosexual men ranged from a low of 44% in Washington, D.C. to 65% in New York City to a high of 68% in San Francisco.

In 1984, the prevalence of the HIV antibody in population of IV drug users ranged from a low of 9% in San Francisco to a high of 68% in New York City.

In 1983-1985, the prevalence of the HIV antibody in populations of hemophilia patients ranged from 46% to 75%.

The period of time between known exposure to the HIV virus and seroconversion ranges from 19 days to 12 weeks.

AIDS in adults usually develops more than two years after HIV infection and may appear more than five years after seroconversion.

The three-year incidence of AIDS among all HIV seropositive subjects in a study of five cohorts (three groups of homosexual men, one group of IV drug users and one group of hemophilia patients) ranged from 8.0% to 34.2%.

Prevalence of AIDS

A total of 21,517 cases of AIDS were reported in the United States by June 9, 1986.

AIDS cases have been reported from all 50 states, the District of Columbia and 3 U.S. territories.

Although the number of new AIDS cases continues to increase each year, the rate of increase has diminished, as shown below.

The length of time required for a doubling of the cumulative number of AIDS cases in the U.S. has increased from 5 months in 1982 to 11 months in January, 1986.

The annual incidence rate of AIDS in the U.S. has increased from 0.11 cases per 100,00 persons in 1981 to 1.43 cases per 100,000 persons for the year ending May 31, 1984.

The prevalence of AIDS in the U.S. as of June 9, 1986, was 94.5 cases per million population. Broad geographical variation exists, with the highest prevalence rates recorded in New York City (722.0 cases per million) and San Francisco (684.8 cases per million). Those two cities accounted for 41% of all 21,517 AIDS cases reported in the U.S. by June 9, 1986.

In the U.S., 95% of AIDS cases have occurred to persons belonging to one or more groups known to be at high risk for AIDS, including homosexual or bisexual males, intravenous drug abusers, hemophilia or coagulation disorder patients, blood transfusion recipients or heterosexual contacts of persons with AIDS or at risk of AIDS.

Of the 6% of AIDS cases initially reported without identifying risk factors, about 33% are persons from countries where heterosexual transmission accounts for many AIDS cases. Further interviewing of available members of the remaining group identified risk factors for all but 33%. Thus, less than 2% of all AIDS cases ultimately remained without identifiable risk factors.

Opportunistic infections occur in all AIDS patients. To date in the U.S., 58% of AIDS patients have had Pneumocystis carinii pneumonia (PCP), 17% have had Kaposi's sarcoma (KS), 5% have had both PCP and KS and 19% have had other opportunistic infections.

Kaposi's sarcoma has been reported in over 34% of homosexual men with AIDS, but in only 6% of AIDS patients in all other groups.

Mortality from AIDS

As of June 9, 1986, 11,713 people died in the U.S. from AIDS, representing 54% of all known cases.

The case fatality rate is over 75% for persons diagnosed with AIDS for two years or more.

In a follow-up of approximately 3,600 cases of AIDS in New York City and State, the median survival time for gay men was 10 months and for IV drug abusers 7 months.

The median survival of those AIDS patients with Kaposi's sarcoma was 14 months, those with Pneumocystis carinii pneumonia was 7 months and those with other opportunistic infections was 6 months.

Since about 90% of AIDS patients are between 20-49 years old, AIDS results in a disproportionate number of years of potential life lost (YPLL) before age 65. In single men ages 25-44 years in the U.S., AIDS caused nearly as many YPLL in 1984 (32,300) as did cancer (39,500) in 1980. In Manhattan and San Francisco in 1984, AIDS was the leading cause of YPLL among 25-44 year-old men with more YPLL than for accidents, homicide, suicide, and cancer combined.

Modes of Transmission

All persons with AIDS or with antibodies to HIV are considered carriers of the virus, capable of transmitting the infection to others.

Although HIV has been isolated from the blood, semen, saliva, tears, urine and breast milk of infected individuals, the only known transmission has been via blood and semen. Studies of nonsexual household contacts of AIDS patients indicate that casual contact with saliva and tears does not result in transmission of infection.

HIV infection can persist even in asymptomatic individuals for at least several years. Retrovirus infections in animals persist for life. The presence of HIV antibody is presumptive evidence of current infection and infectibility.

In most cases, HIV appears to have been transmitted through one or more of four routes: sexual contact, intravenous drug administration with contaminated needles, administration of blood and blood products, and passage of the virus from infected mothers to their unborn babies.

After four years of close observation of AIDS in the U.S., no evidence exists showing the transmission of HIV infection or AIDS through food, by arthropods, or from casual contact. Similarly, no cases of AIDS or HIV transmission have been attributed to the use of immunoglobulins or the hepatitis B vaccine.

The risk of HIV transmission through blood or blood products transfusion has been virtually eliminated by current practices, which include screening of donated blood for HIV antibodies and heat treatment of clotting factor concentrates.

The risk of perinatal transmission of HIV by infected mothers is not known precisely, but was observed in one study to be as high as 65%.

No known transmission of HIV infection to household contacts of infected persons has been detected when the household contacts have not been sex partners or infants of infected mothers.

No known transmission of HIV infection has occurred from the preparation or serving of food or beverages. No known risk of transmission to coworkers, clients, or consumers exists from HIV-infected workers in other worksites (e.g., offices, schools, factories, construction sites).

The risk of acquiring HIV infection from a needlestick exposure to a source patient is much less than 1%. For comparison, the risk of hepatitis B infection following a needlestick from a hepatitis B carrier ranges from 6%-30%.

AIDS Outside the United States

In Europe, a cumulative total of 1,573 cases of AIDS have been diagnosed through September 1985. The highest prevalence rates were recorded in Belgium (11.9 per million), Switzerland (11.8 per million) and Denmark (11.2 per million), but were far below the estimated prevalence of AIDS in the U.S. in September 1985 of 60.0 per million.

In Europe, 92% of the AIDS patients as of September 1985 were males and 88% were between 20-49 years of age. Of the total European AIDS cases, 69% were homosexual or bisexual men, 6% were IV drug abusers, 2% were both of the above, 3% were hemophilia patients, 2% were transfusion recipients without other risk factors, 2% were unknown, and 11% had no known risk factors. Of those without identifiable risk factors, up to 72% were from countries where heterosexual transmission of HIV occurs commonly.

The Pan-American Health Organization reports 1,685 cases of AIDS in the Americas outside the U.S. through December 31, 1985. The majority of those cases were from Brazil (540), Canada (435) and Haiti (377).

Cases of AIDS have been reported in residents of nearly 20 African countries, but studies of AIDS have been conducted primarily in Zaire and Rwanda. In Zaire, the male-to-female ratio was approximately 1:1 and the annual incidence was estimated at 17-40 per 100,000 population. In the U.S., the male-to-female ratio among adults is currently 14.2:1. In 1984, the annual incidence of AIDS in the U.S. among single males was 14.3 per 100,000, and among the general population, 1.4 per 100,000.

HIV and AIDS in Homosexual and Bisexual Men

In a cohort of 6,875 homosexual and bisexual men in San Francisco, the prevalence of HIV antibodies had reached 73.1% by August, 1985.

In the San Francisco cohort, 3.8% of the entire group and 5.2% of those with HIV antibodies had developed AIDS by August, 1985.

Two-thirds of the men in the San Francisco cohort study who had HIV infections for over five years had not developed AIDS or AIDS-related illness.

The seroprevalence of HIV antibody among a group of homosexual males in New York City was 65% in a 1985 study.

The three year incidence of AIDS was 34.2% in a, cohort of HIV seropositive homosexuals in Manhattan.

Intervention Data

Changes in Sexual Behavior Among High Risk Groups

Surveys of risk factors for HIV infections among gay and bisexual men in San Francisco revealed that the percentage of persons with more than one sexual partner during the 30 days prior to the survey decreased from 49% in August, 1984, to 26% in April, 1985. The percentage of persons who were monogamous, celibate or had no unsafe sexual activity outside a primary relationship increased from 69% in August, 1984, to 81% in April, 1985. (In this study, an unsafe sexual practice included anal intercourse without a condom and oral sex with exchange of semen.)

Cases of rectal gonorrhea in men attending the San Francisco City Health Department clinics declined 73% between 1980-1984.

Between 1980-1983, rates of rectal and pharyngeal gonorrhea in men in Manhattan decreased 59%.

Use of Health Services

The initial hospitalization of AIDS patients entails a mean length of stay of 31 days. Rehospitalization for new or recurrent opportunistic infections is frequent.

A New York City study found that 14% of AIDS patients died during the initial hospitalization, 35% spent less than 30% of the time in the hospital after the initial hospitalization, 16% spent between 30%-50% of the time hospitalized and the remaining 35% spent more than 50% of the time in the hospital.

It is estimated that the first 10,000 patients with AIDS will spend a total of 1,677,900 days in the hospital.

A California study reported that AIDS patients had an average of 6.4 hospitalizations at an average length of stay of 14 days over an 18-month average lifespan.

Economic Impact

An estimated $147,000 is spent on the entire hospital care of each AIDS patient.

A study of the economic costs of AIDS estimated that in 1984 each AIDS patient was admitted to a hospital an average of 1.7 times for an average length of hospitalization of 13.0 days. The average charge per hospital day was $740. The average outpatient charge was estimated at $2,015 for each AIDS case in 1984.

The total economic impact of the first 10,000 cases of AIDS in the U.S. has been estimated at $6.3 billion, including $1.4 billion on direct hospitalization expenses, $189 million in lost wages due to disability and $4.6 billion in lost earnings from premature death.

The direct economic costs of AIDS in 1985 have been estimated at a total of $836.5 million, including $517.4 million in personal medical care costs and $319.1 million in non-personal costs (research, blood screening, education and prevention services).

The indirect economic costs of AIDS in 1985 were estimated at $3,285.6 million, including $205.7 million in morbidity costs (value of productivity losses due to illness and disability) and $3,079.0 million in mortality costs (value of earnings lost due of premature death).

According to these estimates, the total direct and indirect costs of AIDS in 1985 were $4,122.1 million.

In 1984, total personal health care expenditures in the U.S. were estimated at $387.4 billion, and total indirect costs of morbidity and mortality of all illness and death were estimated at $304.7 billion, for a total of $692.1 billion in direct and indirect costs. Estimates of the direct and indirect costs of AIDS for 1984 total $1.9 billion, a fraction of 1% of the total economic costs for all diseases that year.

Expenditures for Research on AIDS

Research expenditures on AIDS have increased from $60 million in 1984 to $113.6 million in 1985 to $233.7 million in 1986.

The expenditures for AIDS health education, information and support services by the Centers for Disease Control, State and local governments and community-based volunteer organizations have been estimated at $19.3–$23.3 million for 1985 and $27.6–$31.6 million for 1986.

What are AIDS and HIV?AIDS stands for acquired immunodeficiency syndrome, a condition first reported in the United States in 1981, that has since beco

AIDS stands for acquired immunodeficiency syndrome, a condition first reported in the United States in 1981, that has since become a major worldwide epidemic.

AIDS is caused by HIV (human immunodeficiency virus). By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. The term AIDS applies to the most advanced stages of HIV infection.

How is HIV spread?

There are several common ways that HIV can be passed from person to person, including:

• Having unprotected sex with someone who is infected
• Using needles or syringes that have been used by people who are infected
• Receiving infected blood products or transplanted organs (Since 1985, the United States actively tests all donated blood for HIV; therefore, the risk of getting HIV in this way in the United States is now extremely low.)
• Transmission from mother to child – An infected mother may pass the virus to her developing fetus during pregnancy, during birth, or through breastfeeding.

If you have a sexually transmitted disease, you may be at higher risk for getting infected with HIV during sex with an HIV-infected partner.

There is no evidence that HIV is spread by contact with saliva or through casual contact, such as shaking hands or hugging, or the sharing of food utensils, towels and bedding, swimming pools, telephones, or toilet seats. HIV is not spread by biting insects such as mosquitoes or bedbugs.

What is the treatment for HIV/AIDS?

Although when AIDS first appeared there were few treatments, researchers have now developed drugs that can help fight both HIV and the related infections and cancers that come with it. Treatment advances have improved the survival rates and decreased progression of HIV disease in developed countries like the United States, where antiretroviral drugs are available.

Additional treatment information is available from the National Institute of Allergy and Infection Diseases at NIH. The NIH is currently conducting many clinical trials related to HIV/AIDS to test treatments and therapies. These trials are sponsored and co-sponsored by various Institutes, including the NICHD.

The NICHD supports and conducts research related to HIV/AIDS in specific groups of people, including pregnant and non-pregnant women, infants and children, and adolescents and young adults. The information below applies to those groups.

How does HIV/AIDS affect women?

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 19.2 million women are living with HIV/AIDS throughout the world. In many countries, the rate of HIV infection in women is rising faster than in any other group.

Worldwide, more than 80 percent of HIV infections are spread by heterosexual sex (vaginal intercourse); women are particularly at risk of contracting HIV through this type of contact. HIV is increasing most dramatically among African American and Hispanic women.

Although most of the signs and symptoms of HIV infection are similar in men and women, some are more specific to females. For example:

• Vaginal yeast infections may be chronic, more severe, and difficult to treat in women with HIV infection than in women who are uninfected.
• Pelvic inflammatory disease, an infection of the female reproductive organs, may also be more frequent and severe in women with HIV infection.
• Human papillomavirus (HPV) infections, which cause genital warts, may occur more frequently in HIV-infected women, and can lead to pre-cancerous lesions of the cervix or cancer of the cervix.

The NICHD, along with other Institutes, supports studies to determine what aspects of HIV are specific to women and the best treatments for these symptoms.

How does HIV affect pregnant women and infants?

Women can give HIV to their babies during pregnancy, while giving birth, or through breastfeeding.

But, there are effective ways to prevent the spread of mother-to-infant transmission of HIV:

• Taking anti-HIV drugs during pregnancy—either a drug called zidovudine or AZT alone or in combination with other drugs called highly active antiretroviral therapy (HAART)—a mother can significantly reduce the chances that her baby will get infected with HIV.
• Delivering the baby by cesarean section, and doing so before the mother’s uterine membranes rupture naturally, reduces transmission that may occur during the birth process. Use of anti-HIV drugs during pregnancy and delivery, combined with a cesarean section in women with certain levels of HIV in their blood, can reduce the chance that the baby will be infected to less than 2 percent.
• Avoidance of breastfeeding by an HIV-infected mother. HIV can be spread to babies through the breast milk of mothers infected with the virus. The American Academy of Pediatrics recommends that, in countries such as the United States, where infant formula is safe and is often available and affordable, HIV-infected women feed their infants commercially available formula instead of breastfeeding.

Approximately one-fourth to one-half of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV infection of newborns is very rare in the United States because women are tested for HIV during pregnancy, and women with HIV infection receive anti-HIV drugs during pregnancy, cesarean delivery if their HIV blood levels are high, and are advised not to breastfeed their infants.

How does HIV affect children and adolescents?

It is estimated that approximately 10,000 children are living with HIV infection in the United States. In the United States, the number of infants born with HIV infection has dramatically decreased from about 2,000 a year to fewer than 200 a year due to identification of HIV infection in pregnant women and use of anti-HIV drugs during pregnancy, cesarean delivery, and avoidance of breastfeeding.

In contrast to the United States, mother-to-child transmission in developing countries remains a major problem; about 700,000 infants are newly infected with HIV each year because most women are not screened for HIV during pregnancy, anti-HIV drugs are not available, and safe alternatives to breastfeeding are not available.

Prior to 1985, when screening of the nation's blood supply for HIV began, some children as well as adults were infected through transfusions with blood or blood products contaminated with HIV, but this is now rare in the United States.

In contrast to the dramatic decrease in mother-to-child transmission of HIV infection, the number of cases of HIV infection in adolescents and young adults continues to increase in the United States. About one-third to one-half of new HIV infections in the United States are among adolescents and young adults.

Most HIV-infected adolescents and young adults are exposed to the virus through unprotected sex; some teens and young adults are also infected through injection drug use. In addition, an increasing number of children who were infected as infants are now surviving to adolescence.