Bloodborne HIV: Don't Get Stuck!

Unexplained infections in children:

National survey, 2011: A 2011 random sample national survey tested adults and children aged 0-5 years for HIV. An estimated 17% (12 of 70) HIV positive children had mothers who tested HIV-negative. This percentage is calculated as follows: The study found 70 HIV-positive children (estimated from the report that 0.7% of 9,946 children tested were HIV-positive). Of these 70 children, 41 mother were HIV-positive (estimated from the report 8.1% of the children of 505 HIV-positive mothers were HIV-positive). An estimated 17 HIV-positive children had mothers who were not tested (estimated from the report 1.2% of the children of 1,415 untested mothers were HIV-positive). That leaves 22 (= 70 – 41 – 17) HIV-positive children with mothers who tested HIV-negative. Source:  Table 8.13 in: Uganda Ministry of Health, and ICF International. Uganda AIDS Indicator Survey (UAIS) 2011. Calverton: ICF International, 2012. Available at: https://dhsprogram.com/publications/publication-AIS10-AIS-Final-Reports.cfm (accessed 6 December 2018).

National survey, 2004-5: A 2004-5 random sample national survey tested adults and children aged 0-5 years for HIV. An estimated 19% (11 of 59) HIV-positive children had mothers who tested HIV-negative. This percentage is calculated as follows: The study found 59 HIV-positive children (estimated from the report that 0.7% of 8,374 children tested were HIV-positive). Of these 59 children, 37 mother were HIV-positive (estimated from the report 10.2% of the children of 364 HIV-positive mothers were HIV-positive). An estimated 11 HIV-positive children had mothers who were not tested (estimated from the report 0.8% of the children of 1,339 untested mothers were HIV-positive). That leaves 11 (= 59 – 37 – 11) HIV-positive children with mothers who tested HIV-negative. A 2004-5 random sample national survey tested adults and children aged 0-5 years for HIV. Among 44 HIV-positive children whose mothers were tested, an estimated 16% (7) tested HIV-negative; an estimated 11 HIV-positive children had mothers who were not tested. These numbers are calculated from reported data as follows: out of 364 children with HIV-positive mothers, 10.2% [37] tested HIV-positive; out of 6,671 children with HIV-negative mothers, 0.1% [= 7] were HIV-positive; and from 1,339 children with untested mothers, 0.8% [= 11] were HIV-positive. Source: Table 8.13 in: Ministry of Health, Uganda. Uganda HIV/AIDS Sero-Behavioural Survey 2004-05. Kampala: Ministry of Health 2006. Available at: http://www.measuredhs.com/pubs/pdf/AIS2/AIS2.pdf (accessed 5 January 2012).

Hospitalized children, 1991-93: In 1991-93, WHO’s Global Programme on AIDS arranged for hospitals to test children aged 6-59 months (1/2 to 5 years old) admitted to pediatric care and their mothers in 4 cities in Africa: Kigali, Rwanda; Dar es Salaam, Tanzania; Kampala, Uganda; and Lusaka, Zambia. The studies tested 5,593 child-mother pairs, of which 61 (1.1% of 5,593) children were HIV-positive with HIV-negative mothers. The reports on this study do not give any breakdown by country. The authors conclude (incredibly!): “The risk of nosocomial and non-perinatally acquired HIV infection appears low among these populations.” This shows a double-standard for Africa; if 1% of inpatient Europeans had unexpected HIV infections, such a conclusion would be unacceptable. Source: Hitimana D, Luo-Mutti C, Madraa B, et al. A multicentre matched case control study of possible nosocomial HIV-1 transmission in infants and children in developing countries. 9^th Int Conf AIDS, Berlin 6-11 June 1993. Abstract no. WS-C13-2. 

Children with Kaposi’s sarcoma, 1989-94: In a 1989-94 study of children with Kaposi’s sarcoma, 5 of 26 mothers of HIV-positive children tested HIV-negative. All children were less than 15 years old. Source: Zeigler JL, Katongole-Mbidde E. Kaposi’s sarcoma in childhood: an analysis of 100 cases from Uganda and relationship to HIV infection. Int J Cancer 1996, 65: 200-203. Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/8567117 (accessed 13 January 2012).

Unexplained infections in adults, 2003-6: A study in Rakai, Uganda, in 2003-06 recruited HIV-negative men, circumcised some men but not others, and then followed them to see who got HIV. During the trial, 67 men got HIV. Among these 67 men, 6 reported no sex partners and 10 reported always using condoms; these 16 men with no reported sex risk got HIV at the rate of 0.7% per year. The remaining 51 men who reported sex risk got HIV at the rate of 1.2% per year. Source: Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. Lancet 2007; 369: 657-666. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60313-4/fulltext (accessed 15 October 2018).