CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Mother-To-Child Transmission (MTCT) is responsible for more than 700,000 estimated new HIV infections in children worldwide yearly. In a single day, more than 1800 babies contract HIV from their mothers worldwide; and many of these cases occur in Africa. The probability of infection from mothers who do not receive treatment is higher in Africa (25% – 52%) than the United States (US) or Europe (12%-30%).
Human Immunodeficiency Virus (HIV) is easily transmitted through unprotected (i.e. without condom use) anal intercourse (penis in anus) than other sexual activities. It is also more likely to be transmitted to the receptive partner than the insertive partner in both vaginal (8/10,000 exposures) and anal (138/10,000 exposures) intercourse. Thus, women are more vulnerable to HIV infection because they are more often the receptive partners, especially in sub-Saharan Africa. In the world today, Nigeria accounts for about 10% of all HIV/AIDS cases. Women constitute 57% of adults infected with HIV in Nigeria, a prevalence which is higher than that of the global figure of 48%. Sixty percent of new infections occur in the 15 – 25-year-old age group but the prevalence is highest among productive young people between the ages of 20 – 29 years. Heterosexual transmission accounts for 80% of all infections. The pandemic is having a ruinous effect on the reproductive health of women in Nigeria. The number of HIV-positive women has increased, with an attendant alarming increase in the number of HIV-positive children in recent years. In 2007, around 370,000 children under 15 became infected with HIV, mainly through mother-to-child transmission. About 90% of these MTCT infections occurred in Africa where AIDS is beginning to reverse decades of steady progress in child survival. In high income countries of the world, MTCT has been virtually eliminated thanks to effective voluntary testing and counseling, access to antiretroviral therapy, safe delivery practices, and the widespread availability and safe use of breast-milk substitutes. If these interventions were used worldwide, they could save lives of thousands of children each year. Hence, there is an urgent need to combat this menace. The “Prevention of Mother-to-Child Transmission of HIV” service was started in October 2003 at Aminu Kano Teaching Hospital, Kano. Following the designation of this center as a service center for the program of prevention of mother-to-child transmission, a committee was formed, which involved pediatricians, obstetricians, nurses, pharmacists, public health physicians and counselors to run the program. It is therefore pertinent to determine the knowledge and awareness about HIV/ AIDS and mother-to-child transmission among mothers attending the pediatric HIV clinic. The information obtained will influence the counseling and education of patients and the community about HIV/AIDS. This will further decrease mother- to- child transmission of HIV/AIDS.