Assessing Medical Neglect in HIV-Exposed or Infected Children
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BRIEF REPORT
Assessing Medical Neglect in HIV-Exposed or Infected Children Ellen R. Conroy 1,2 & Barbara L. Knox 3 & Sheryl L. Henderson 3
# Springer Nature Switzerland AG 2019
Abstract Human Immunodeficiency Virus (HIV) causes a chronic illness requiring lifelong medical care to prevent opportunistic infections and death. It is important to identify medical neglect in children that are perinatally exposed to or living with human immunodeficiency virus and to take steps to prevent it. Diagnosis of medical neglect must be considered in the context of the caregivers’ understanding of the risks of harm, and the logistical, cultural and social factors that may influence their actions or non-actions. When medical neglect as failure of treatment or prevention of infection is suspected, medical providers should work collaboratively with caregivers to assess and address barriers to adherence and to provide resources and support. Medical neglect may be diagnosed if repeated preventive efforts fail. Keywords Breastfeeding . HIV . HIV Prevention . HIV transmission . HIV treatment . Medical neglect . Medication noncompliance . Pediatric HIV
Since the Acquired Immune Deficiency Syndrome (AIDS) and its causative agent the Human Immunodeficiency Virus (HIV) was recognized over thirty years ago, rapid progress has been made in prevention and treatment modalities. HIV is transmitted from person to person via blood, breast milk, semen, vaginal secretions, and rectal secretions. Among children, the most common means of HIV acquisition occurs perinatally during delivery or postnatally through breastfeeding (Mofenson 1997), and in rare circumstances, through premastication – the prewarming and prechewing of food for infants. (Centers for Disease Control and Prevention 2011; Gaur et al. 2009; Ivy et al. 2012). The future for children born with HIV infection today is not as dire as it was 20 to 30 years ago. Advances in the development of antiretroviral (ARV) therapy has turned what was once a debilitating and fatal illness into a manageable chronic illness. However, there
continues to be no cure, and if not treated appropriately, HIV infection can lead to significant illness and mortality. This article will summarize current knowledge about the postnatal risks of HIV to exposed and infected children and identify barriers to optimal medical care by caregivers. This information can be useful in recognizing when a situation should be evaluated for medical neglect in the context of prevention and treatment of HIV infection in infants and children. There are two types of situations in which the question of medical neglect may arise–when there is a failure of the caregiver 1) to take the appropriate steps to prevent an infant from acquiring HIV, or 2) to seek and provide the appropriate medical care for an infant or child living with HIV.
Background * Sheryl L. Henderson [email protected] 1
Medical School of the University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
2
Present address: Pediatric Residen
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