Special Health Issues: HIV Guidelines

The incidence of pediatric HIV in the District of Columbia has declined dramatically due to effective prevention and treatment strategies. Modern antiretroviral therapies (ART) enable providers to effectively manage HIV, allowing children with HIV to lead long, healthy lives.

Preventing Perinatal HIV Transmission

The best way to prevent pediatric HIV is to prevent transmission from mother to child.

• Universal Screening for Pregnant Women: Routine, opt-out HIV screening for all pregnant women is the standard of care. Identifying maternal HIV status is critical for the health of both the mother and the infant.
• Antiretroviral Therapy (ART): With currently recommended ART for the pregnant person and their infant, the risk of perinatal HIV transmission can be reduced to less than 1%.

Care for HIV-Exposed Infants

• Early Diagnosis: Early diagnosis is critical. HIV infection can be presumptively ruled out or confirmed in most HIV-exposed infants by 2 to 4 months of age using virologic testing.
• Prophylactic Treatment: Infants exposed to HIV should receive prophylactic ART as soon as possible after birth to reduce the risk of transmission.

Principles of Care for Children with HIV

Primary care for children with HIV should be comprehensive, family-centered, and coordinated with specialists. Key principles include:

• Multidisciplinary Team: Care should be provided in coordination with a specialist in pediatric HIV.
• Support Services: Families benefit from integrated support services, including nutrition, mental health, and case management.
• Adherence: Ongoing support for the family's ability to adhere to the treatment plan is essential.
• Confidentiality and Disclosure: Providers should have sensitive, age-appropriate conversations about confidentiality and disclosure with the child and family.

Clinical Guidelines & Resources

HIV treatment guidelines are updated regularly. Providers must always refer to the official sources for the most current clinical information.

• Treatment Guidelines for Treating Pediatric HIV (NIH): The official, regularly updated federal guidelines for the medical management of infants, children, and adolescents with HIV.
• HIV Testing and Youth (CDC): The Centers for Disease Control and Prevention's resource hub for information on pediatric HIV prevention, diagnosis, and data.
• Find HIV/AIDS Medical Care (HRSA): A tool from the Health Resources and Services Administration (HRSA) to help patients find local HIV medical services.

This concludes the HIV Guidelines portion of the Special Health Issues section. The next page contains information on Child Abuse and Neglect.