Living in the shadows.

• Position: Children with HIV

Every day, 1,000 children become infected with HIV. UNAIDS estimates that, by the end of 1997, 1 million children under the age of 15 will be living with the virus and suffering the physical and psychological consequences of infection. Since the beginning of the epidemic, well over 2 million HIV-positive children have been born to HIV-positive mothers, and hundreds of thousands of children have acquired HIV from blood transfusions and through sex or drug use. Over 9 million children are estimated to have lost their mothers to AIDS.

"AIDS is the most recognized disease in the world today", said Dr. Peter Piot, Executive Director of UNAIDS, in launching the campaign, "but the disastrous impact it is having on children has not been given enough attention. If the spread of HIV is not rapidly contained, the gains made in reducing infant and child death rates will be reversed in many countries." Estimates quoted in the report indicate that by the year 2010 AIDS may increase infant mortality by as much as 75 per cent and under-five child mortality by more than 100 per cent in the most hard-hit countries in the world.

"Within a little more than a decade, AIDS will be a major cause of death among children", stresses Carol Bellamy, Executive Director of the United Nations Children's Fund (UNICEF). "But children do not have to contract HIV to be profoundly harmed by it. The number of orphans are growing dramatically, children are traumatized by watching parents die, forced out of school to take the place of adults at home, and often suffer from discrimination. HIV has become a real threat to children's rights."

According to the report, more children than ever before are contracting HIV, and there is no sign that the infection rate is slowing. In 1996 alone, 400,000 children under the age of 15 years became infected worldwide. Around 90 per cent of these children acquire the virus from their HIV-positive mothers, whether before or during birth or through breastfeeding. And women of child-bearing age are now making up an ever-increasing proportion of people with HIV worldwide: today, AIDS kills more women than men in sub-Saharan Africa.

In the longer term, therefore, reducing the vulnerability of infants to HIV infection means increasing women's control over their situations, improving their ability to take decisions about their own reproductive and sexual health, and increasing the knowledge and sense of responsibility of both men and women about HIV...