Caring with confidence 
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Caring with confidence: 
practical information for health workers 
who prevent and treat HIV infection in children

This briefing paper was produced in 1997 and focuses on children aged from birth to five years. It is intended primarily for health workers in developing countries who are responsible for the management of young children with HIV and AIDS. The briefing paper will also be of interest to educators, NGOs and those working with community organisations who are involved with HIV prevention and the care of young children living with HIV/AIDS.

Contents
 
Acknowledgements 
Introduction 
 
Section 1: How HIV and AIDS affect young children
 

• 1.1  Children infected with HIV

  • Facts about HIV/AIDS and children

  • Where are children most affected?

  • How does HIV/AIDS affect child health?

• 1.2  Children affected by HIV

  • Impact of HIV/AIDS on infant and child mortality

• 1.3  Children vulnerable to HIV 
   

Section 2: Preventing HIV infection in young children 
 

• 2.1 Mother-to-child transmission

  • How is HIV transmitted to children?

  • When is HIV transmitted?

  • Risk factors

• 2.2 Preventing and treating HIV infection in women

  • Preventing infection in women

  • Factors which increase HIV risk

  • How Improved STD control can reduce HIV transmission 

  • If a woman already has HIV infection

  • HIV and women's reproductive choices

  • Antiretroviral therapy

• 2.3 Breastfeeding

  • Preventing HIV transmission through breastfeeding

  • 1. Consider the possibility that the mother may have HIV

    • Counselling and testing

  • 2. Help the mother to make a decision about infant feeding

    • Breastfeeding and HIV: assessing the risk

  • 3. Advise the mother about how to feed the infant safely

    • Modified breastfeeding

    • Alternatives to breastfeeding

    • Reducing the risks associated with giving alternatives to breastmilk

  • 4. Follow up the infant's growth and general health

• 2.4 Other interventions to reduce transmission

  • Improving nutrition during pregnancy

  • What can health workers do?

  • Safe delivery at home

  • Medical procedures during pregnancy and delivery

• 2.5 Transmission through blood transfusion

  • Preventing transmission through blood transfusion

• 2.6 Acquired infection 
   

Section 3: Diagnosis, treatment and care 
 

• 3.1 Diagnosis and testing of infected children

  • Diagnosis

  • Clinical signs and symptoms

  • HIV counselling and testing

  • Birth to 6 Months

  • Issues to consider in testing children for HIV

  • Diagnostic tests

• 3.2 Treatment and care

  • Basic care and support needs for all children - with and without HIV

  • Prevention, treatment and supportive care at home

  • Preventing transmission of HIV at home

  • Helping children to stay well

  • Nutrition and children with HIV and AIDS

  • Feeding and illness

  • Safe preparation of food

  • Taking care of common conditions

  • How to give oral rehydration salts (ORS) solution

  • How to make gentian violet solution

  • Giving medicines to children

  • Management of common infections at primary care level

  • Clinical follow-up

  • Referral and treatment

  • Immunisation: protecting against common childhood infections

  • Palliative care in terminal HIV/AIDS

  • Drugs for treatment of children with HIV and AIDS

• 3.3 Affected children

  • What can health workers do?

  • Child rights and HIV and AIDS

  • Community-based support programme

  • Strategies for dealing with children orphaned by HIV and AIDS 
     

Section 4: Issues for health workers 
 

• 4.1 Pressures on health workers

• 4.2 Preventing transmission in health facilities

  • Preventing tuberculosis

  • Safety precautions

  • Care after exposure

• 4.3 Advising and counselling caregivers

  • Children living positively

  • Talking to children about HIV and AIDS

  • Confidentiality and children

  • Dealing with illness and death in a young child

  • Dealing with children's questions

  • Planning for a child's future 
     

Section 5: Selected resources 
 

Glossary

Appendix 1 - Basic Facts about HIV and AIDS

Appendix 2 - Example of a workshop to explore issues around HIV/AIDS and young children

 
 
Published as part of the World AIDS Campaign with support from
 

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