Growing up, I have always found joy in helping children, they hold a curiosity that isn’t found in many adults and have such an optimist outlook on life. When I was twelve years old my family and I traveled to Vietnam. While I was there I was exposed to many things that I had not been exposed to in the US. I saw the living situations of many families and how poverty was a norm. One thought that I could not get out of my head while on the trip, was the lack of resources families had for their children and how detrimental it could be for their health. It never occurred to me how some of the simplest medications were luxuries. Due to my passion for helping children I have become very interested in their health. While in India I plan on researching the health of children ages 1-10, specifically children with HIV and malnutrition. I wish to look at the behavior of families who have children diagnosed with HIV and their willingness to seek treatment, and if there are any behavior differences between HIV positive and HIV negative children. I believe that conducting this research while in India will bring me one step closer to achieving my goal in become a pediatrician. 

            

HIV is a struggle in the US, but much of it is due to sexual contact and drug use. The populations that are most effected in the US are gay men, African Americans, Latinos, and Transgenders. Out of the 1.1 million people living with HIV in the USA, one in seven are aware they have HIV (avert.org). In 2010 President Obama created the USA’s first National HIV/AIDS strategy (PACHA). The goal was to reduce the spread of HIV, to increase access to care, improve the health of those will HIV, and to overall have a national response to the epidemic. With Trump’s election in 2016, many members of the strategy have resigned or been fired, leaving no one to run PACHA. In the US, unlike India, the problem isn’t resources not being available to people, but educating people on those resources and how to limit the sexual transmission of HIV. 

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HIV positive children are very prominent in India, but although they are prominent “only 54% of children exposed to HIV [are] tested within the recommended two months” (avert.org). One of the main ways HIV is transmitted in India is from mother to child. HIV can be transmitted through pregnancy, labor, or breastfeeding, “in populations where breast feeding is the norm, it accounts for more than one-third of all transmission” (Bashiru, 2015, p.89). Since the introduction of prophylactic antiretroviral medicine, “HIV- infected mothers and infants can reduce mother-to-child transmission (MTCT) of HIV by almost 68 percent” (Darak, 2012, p.2). Over the years that number has been reduced down to 2%. Due to the success of antiretroviral treatment (ART) and non-antiretroviral (AVT) strategies, developed countries, such as the US, have almost completely eliminated MTCT of HIV (p.2). This is due mostly to many mothers having access to those medication and treatment options. In developing countries, such as India only 53% of eligible women receive “antiretroviral medication to prevent mother-to-child-transmission of HIV” (Darak, 2012, p.2). In 2011 the UN launched a program called Prevention of Parent-to-Child Transmission (PMTCT), which shortly after was adopted by India. Although the PMTCT scaled the country of India to increase HIV counseling and testing facilities, only 20% of pregnant woman were counseled and tested for HIV, 30% were infected, and only 60% of pregnant, women infected “received a single dose of Nevirapine for PMTCT, which was the National protocol”(Darak, 2012, p.2). This means only 3.6% of women tested for HIV in India were given treatment. Compared to the U.S. a developed country, who has practically eliminated mother-to-child-transmission of HIV, it is unacceptable. By going on this study abroad program, I plan to investigate why these resources are not reaching everyone and research how to bring these resources to those in need. 

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With children developing HIV in India, it puts them at a huge risk for malnutrition. This can cause wasting, stunting and being underweight. In a research study done by Raj, McDougal, and Silverman (2015) 19.8% of children under five in India were found to have modern to severe wasting, 48% of children were found to have moderate to severe stunting, and 42% of children were found to be moderately to severely underweight (p.119). With the sample for that study being 41,265, that equates to 19,897 children being stunted and 17,331 being underweight. There are other affects with malnutrition, skin and hair color changes are common, hair texture becomes dry and brittle and the skin looks aged with hyperpigmentation (Tripathi, 2016). Due to poverty, rural residency, and family size, families in India do not have access to good quality food or have the money to purchase enough food to feed their entire family. This causes both HIV and malnutrition in India to be due to lack of resources or resources not being available to families. 

           

 In India I plan on looking at the resources families have, I am interested in seeing how families with HIV positive children seek out treatment, whether or not they have the resources. By interviewing doctors who work specifically in children’s health, I can see how often parents come in with HIV cases. I would look into how often children are tested for HIV and what resources and treatments are available for these families. I am also interested on working with children with HIV first hand to see if they have different behaviors or energy levels then HIV negative children. I would study 10-30 children ages 1-10 to see the varying behavior and energy levels and to depicted if there is a difference in HIV positive and HIV negative children.

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While conducting the study I wish to find ways to bring HIV treatment and resources to women and children in need, as well as food and other nutritional resources. One personal concern I have while researching in India is the openness of parents. Some parents may not feel comfortable having their child being studied or feel the need to not answer questions truthfully. I will try my very best to make sure both parents and children feel comfortable when conducting my research, in hope that I will be able to learn more and help them in the future. 

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Sources:

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HIV and AIDS in the United States of America. (2018). Retrieved from https://www.avert.org/professionals/hiv-around-world/western-central-europe-north-america/usa

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Children, HIV and AIDS. (May 17, 2017). Retrieved from https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/children.

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Bashiru, K. A., Fasoranbaku, A. O., Olukayode, A., Ojurongbe, T. A. (2017). Stability Analysis of Mother-to-child Transmission of HIV/AIDS Dynamic Model with Treatment. Annals Computer Science Series,15.Retrieved from https://login.proxy.lib.fsu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aci&AN=127544519&site=eds-live

 

Darak, S., Panditrao, M., Parchure, R., Kulkarni, V., Kulkarni, S., Janssen, F. (2012). Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services. BMC Public Health, 12.Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=82250457&site=ehost-live

 

Raj, A., McDougal, L., Silverman, J. (2015). Gendered Effects of Siblings on Child Malnutrition in South Asia: Cross-sectional Analysis of Demographic and Health Surveys from Bangladesh India, and Nepal. Maternal & Child Health Journal,19. Retrieved from https://login.proxy.lib.fsu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=103869719&site=eds-live

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Tripathi, S., (2016). Child Malnutrition in India: Causes and Intervention Programmes. International Journal of Multidisciplinary Approach & Studies, 3. Retrieved from https://login.proxy.lib.fsu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=115185425&site=eds-live.