Child survival and perinatal infections with human immunodeficiency virus
J. V. Bennett and M. F. Rogers
Task Force for Child Survival and Development, Carter Center, Atlanta, Ga 30307.
A mathematical model was developed to assess the effect of various assumed
prevalence rates of maternal human immunodeficiency virus (HIV) infection
on perinatally acquired HIV infections and child survival. The model
indicates that for children younger than 5 years, countries with low
baseline mortality rates will experience greater relative increases in
child mortality rates and larger proportions of HIV-caused deaths in
children than countries with high mortality rates. It also suggests that
perinatal HIV infection could become the most common cause of deaths in
children in the developed world if maternal infection rates reach 2% to 3%.
Rates of 25% to 30% would be needed to produce a similar effect in the
developing world. Child survival gains in the last three decades in the
developed world could be quickly erased at low levels of maternal HIV
infection, but gains would not be completely offset in the developing world
until more than 40% of mothers became infected with HIV. When basic
demographic information and the maternal HIV infection rate are known, the
model permits a direct assessment of infant and child mortality caused by
HIV. It can also be used to estimate the prevalence of maternal HIV
infection when values for all other variables are known.
