One of the most significant and distressing global health challenges facing us today is the worldwide pandemic of HIV/AIDS. Of mothers who are HIV positive and who have no intervention, 15-30% will transmit the infection to their child during pregnancy or childbirth or through breast milk (WHO, 2006). It is estimated that each day there are nearly 1,800 new HIV infections in children under age 15 and that 1,400 children under age 15 die daily of AIDS-related illnesses; 95% of these deaths occur in the developing world (UNICEF, 2006).
What is Being Done
The United Nations and UNICEF are working to reverse this pandemic through the Millennium Development Project, with a goal of ending the HIV/AIDS pandemic by the year 2015. This goal requires the initiation of interventions in developing countries where resources are limited. The focus areas include the following:
1. Prevention of mother-to-child transmission of HIV.
2. Provision of treatment for pediatric patients who are HIV positive.
3. Prevention of infection in adolescents and young adults.
4. Protection and support of children who are HIV positive (UNICEF, 2006).
One essential treatment intervention is making cotrimoxazole available for treating children. It is estimated that worldwide four million children need cotrimoxazole, a drug that costs 3 cents a day. This low-cost intervention can make a difference to children infected with HIV/AIDS. A Romanian pediatric clinic (La Central de Copil or "children's center") was developed as one of the first public/private partnerships between the U. S. and Romania to improve access to antiretroviral therapy for children infected with HIV/AIDS. Dramatic improvement in children's health has resulted. In 2003, a clinic modeled after the Romanian clinic was opened in Botswana, with additional clinics projected for Swaziland, Lesotho, Malwai, Uganda, and Burkino Faso.
Many nursing interventions have been aimed at helping to solve the HIV/AIDS crisis worldwide. Among nurses actively involved in this problem are the nurses at the University of California, San Francisco, who have developed numerous important and noteworthy initiatives, including a handbook titled Symptom Management Strategies: A Manual for People Living with HIV/AIDS, based on research conducted on people living with AIDS, their family care givers, and healthcare workers. This handbook has been translated into six languages, including four African languages, and is available without any cost at their Web site (http://aidsnursingucsf.org). A randomized clinical trial is now being conducted to test the efficacy of this manual on a variety of sites. Nurses in sub-Saharan Africa and Eastern Europe are also leading the fight against pediatric AIDS in their homelands as well.
Other groups have been working on this problem as well. Faith-based initiatives, such as Global AIDS Interfaith Alliance, which partners with resource-poor developing countries to foster the implementation of primary, secondary, and tertiary prevention strategies, are making a difference. Another strategy being used to combat HIV/AIDS includes peer education; for instance, in 20 Islamic schools in East Java, Indonesia, HIV/AIDS peer educators are teaching both teachers and students about prevention strategies, which are in turn shared with friends and families (UNICEF, 2006).
Prevention of HIV/AIDS is essential in eradicating this disease. To that end, the WHO UNAIDS HIV Vaccine Initiative is promoting the development of a vaccine to prevent HIV/AIDS (WHO, 2004).
Someone once told me that the word "globe" initially meant a ball created by winding thread together. It is a nice metaphor, anyway, for supporting initiatives that reduce HIV/AIDS in women and children all over the world, because each effort can add strength to the intertwining of multiple threads of caring throughout our globe.
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