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Clinics In Perinatology. 2010 Dec; 37(4):765-76, viii.The World Health Organization's Strategic Approaches to the Prevention of HIV Infection in Infants includes 4 components: primary prevention of HIV-1 infection; prevention of unintended pregnancies among HIV-1-infected women; prevention of transmission of HIV-1 infection from mothers to children; and provision of ongoing support, care, and treatment to HIV-1-infected women and their families. This review focuses on antiretrovirals for secondary prevention of HIV-1 infection-prevention of HIV-1 transmission from an HIV-1-infected woman to her child. Antiretroviral strategies to prevent the mother-to-child transmission of HIV-1 in nonbreastfeeding populations comprise antiretroviral treatment of HIV-1-infected pregnant women needing antiretrovirals for their own health, antiretroviral prophylaxis for HIV-1-infected pregnant women not yet meeting criteria for treatment, and antiretroviral prophylaxis for infants of HIV-1-infected mothers. The review primarily addresses antiretroviral strategies for nonbreastfeeding, HIV-1-infected women and their infants in resource-rich settings, such as the United States. Antiretroviral strategies to prevent antepartum, intrapartum, and early postnatal transmission in resource-poor settings are also addressed, albeit more briefly. Copyright (c) 2010 Elsevier Inc. All rights reserved.
In: The HIV challenge to education: a collection of essays, edited by Carol Coombe. Paris, France, UNESCO, International Institute for Educational Planning, 2004. 253-263. (Education in the Context of HIV / AIDS)Twenty years after the identification of AIDS, some 60 million people have been infected by HIV, a number corresponding to the entire population of France, the United Kingdom or Thailand. Those who have died equal the population of Norway, Sweden, Finland and Denmark combined. Those currently infected - more than 40 million - number more than the entire population of Canada. The number of children thought to be orphaned by HIV/AIDS - some 14 million - is already more than the total population of Ecuador. Over the coming decade their numbers may rise to a staggering 50 million worldwide. In other words, the extent of this pandemic is unprecedented in human history. And the worst is yet to come, for many millions more will be infected, many millions more will die, many millions more will be orphaned. On September 11 2001, more than 3,000 people died in the New York bombings. Every day, around the world, HIV infects at least five times that number. But it is not only individuals who are at risk. The social fabric of whole communities, societies and cultures is threatened. The disease is certain to be a scourge throughout our lifetime. (excerpt)
In: State of the art: AIDS and economics, edited by Steven Forsythe. Washington, D.C., Futures Group International, POLICY Project, 2002 Jul. 2-8.Policymakers need a reasonably complete picture of resource flows from sources to uses that finance HIV/AIDS prevention, care, support, and treatment. Without that picture, they risk misallocation, waste, and faulty strategic planning. For now, in most parts of the developing world, the picture remains largely unpainted. Filling in the details on financing is among the key challenges to HIV/AIDS policymakers today. Limited data for Latin American and Caribbean (LAC) region countries offer virtually the only cases of adequate resource flow data outside the United States. Those countries spent a thousand dollars per person living with HIV/AIDS (PLWHA) in 2000. The U.S. federal government’s Medicaid program for indigents spent 35 times as much for each AIDS patient under its care in that same year. Low-income countries, largely dependent on donor assistance, spent far less per person and per PLWHA—as little as 31 cents per person, and eight dollars per PLWHA in sub-Saharan Africa. These enormous disparities underline a dual challenge: First, use what little money is available in poor countries very effectively; and second, demonstrate to all concerned that more resources must be forthcoming to confront the HIV/AIDS pandemic in poor countries, lest the negative effects swamp any effort to develop. (author's)
In: WHO updates medical eligibility criteria for contraceptives, by Ward Rinehart. Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health Project [INFO], 2004 Aug. 2-4. (INFO Reports No. 1; USAID Grant No. GPH-A-00-02-00003-00)The 2003 Expert Working Group made several changes to the MEC to indicate that women often can safely use IUDs in conditions related to HIV and other sexually transmitted infections (STIs). Taken together, these changes should help reduce some providers’ concerns about offering IUDs in areas where HIV infection and other STIs are common. At the meeting the WHO Expert Working Group concluded that a woman generally can start using an IUD, if she wishes, even if she has AIDS—provided she is receiving ARV therapy and is clinically well—or if she has HIV infection or she is at high risk of HIV infection. The Expert Working Group changed these conditions from category 3 to category 2 for starting IUD use. According to the bulk of research considered at the WHO meeting, IUD use does not increase a woman’s chances of acquiring HIV infection. Women generally can keep their IUDs if they become infected with HIV or develop AIDS while using IUDs (category 2), although IUD users with AIDS should be carefully monitored for pelvic infection. Limited evidence shows that complications of IUD use are no more common among IUD users infected with HIV than among IUD users who are not infected with HIV. Also, IUD use does not increase HIV transmission to sexual partners. (excerpt)
Boston Globe. 2003 Jun 22;  p..A draft report for the UN's AIDS agency has found that even when people use condoms consistently, the failure rate for protection against HIV is an estimated 10 percent, making them a larger risk than portrayed by many advocate groups. The report, which looked at two decades of scientific literature on condoms, is likely to add fuel to a heated political battle on US policy in fighting AIDS in the developing world. (excerpt)