HIV and children
Many children who were born with HIV are in good health, French researchers have found.
The study showed that many characteristics of the children (who had an average age of 15) were in many respects similar to those of school-aged children in France generally. They had comparable height, weight and educational attainment.
The researchers wanted to know more about the health and living conditions of approximately 350 children who became infected with HIV at birth, in the years before 1993. Of this original group, 105 children died, most before effective treatment became available. A further 33 were lost to follow-up.
Seventy-seven per cent of children still in the study were taking HIV treatment and their average CD4 cell count was approximately 550. But a substantial minority – 16% – had stopped taking antiretroviral drugs because they were having problems with taking them properly.
Average viral load was 200 copies/ml, and 55% of those on HIV treatment had an undetectable viral load.
Height, weight and body mass index were similar to the national average, and 84% were in regular schooling.
In all, 84% lived with a family member.
The researchers described these outcomes as “encouraging.”
Access to NHS treatment and care
The rules on entitlement to free NHS care are very complex. Some people (for example people currently applying for asylum) are entitled to free care, while other people face restrictions. But there are many exceptions in the rules and this means that people with HIV should be able to get the treatment that they need. Even if the hospital issues a bill, in practice most people with HIV will not have to pay.
But researchers found that fears of being faced with a large bill meant that some people at risk of HIV weren’t testing as they didn’t see any point in finding out if they had the virus.
Others who were HIV-positive didn’t seek medical care until they were very ill, and then went to an accident and emergency (casualty) department.
Some people relied on alternative and herbal remedies.
If you are concerned about your entitlement to NHS treatment and care, a good place to find information is THT Direct. You can contact this helpline on 0845 1221 200 or at info@tht.org.uk .
Risk of HIV transmission
The researchers looked at the results of 16 studies examining the risk of HIV transmission from anal sex. The same group of researchers had previously reviewed the HIV transmission risks from vaginal sex.
Most of the studies involved gay men and were conducted in the 1980s and 1990s – before effective HIV treatment became available.
After pooling the results of all the studies, they estimated that each single act of receptive, unprotected anal sex involved a 1.4% risk of HIV transmission. This was 18 times higher than the risk arising from a single instance of unprotected vaginal sex.
They also estimated the risk of transmission within relationships where one partner was HIV-positive and the other HIV-negative.
Partners who had both insertive and receptive anal intercourse had a 40% risk of becoming infected with HIV.
People who were only ever the receptive partner had a 40% risk, while those who were exclusively the insertive partner had a 22% risk.
The researchers also calculated the impact of HIV treatment on the risk of transmission.
They estimated that HIV treatment reduced the risk of transmission considerably – to as low as 0.001% per act of unprotected anal sex.
However, the researchers state that “the residual infectiousness could still present a high risk to partners,” and they emphasise the importance of condoms to reduce the risk of HIV transmission.