28.1.1  Minimising risk of infection in children

The most important thing for you to remember in the context of HIV prevention in children is that mother-to-child transmission is the main source of HIV infection. Children at any age who continue to be breastfed from HIV-positive women are at risk of acquiring HIV infection through contaminated breastmilk throughout the time they are breastfed. You should provide feeding advice to mothers according to the national guidelines on infant feeding (this is covered in detail in the Integrated Management of Newborn and Childhood Illness Module).

Remember the AFASS criteria. It is not always possible for a mother to give her child replacement milk; sometimes breastfeeding is the only viable option.

Where one child is HIV positive, it is possible that other family members, including siblings (brothers and sisters), are already infected. Therefore, you should always encourage HIV testing of parents, and young, siblings of HIV-exposed infants and HIV-infected children. You should appreciated that unless an HIV test result is confirmed, infants born to HIV-positive mothers are called HIV-exposed infants, and HIV-infected children are those whose HIV test results are confirmed as being positive.

  • What is the main route of HIV transmission among adults?

  • The main route of HIV transmission among adults is sexual intercourse.

28.1  Critical issues in HIV infection and progression to AIDS in children

28.1.2  Early diagnosis of HIV