The greatest challenge with pediatric HIV patients is getting them to stick with their treatment plans, according to Dr. Percival McNeil, pediatrician and consultant at the Princess Margaret Hospital. "The kids with HIV taking pills and medicines - pills are big, medicines taste bad - they struggle with that," said Dr. McNeil on Saturday during the 2011 Caribbean HIV Conference, being held at Atlantis.
"That's quite a serious issue, so the challenge is to prevent, and if you are unable to prevent, meaning that there are transmissions anyway, then we have to put as much effort as we can into getting them to take their medication. They really do work, the kids do well, they can integrate well and go on to school, and we don't know how far they can go because these kids look very well and they can function well," he said.
The conference, which ends today, brought together almost 2,000 individuals from across the Caribbean to learn about scientific research findings, best practices and to participate in networking opportunities. McNeil's presentation at the conference was entitled, "Long-term follow-up of HIV infected children in The Bahamas".
"There are a lot of kids who are loved, but the actual aspect of love where there is discipline and parenting that says, 'these are the rules, you will take [your medication]', this is the challenge." noted McNeil. He continued, "What we are proposing is as soon as we meet up with [HIV] positive mothers, [that we] really work with them on their parenting skills and whatever their psychosocial needs are, so that they are prepared to deal with the kids as they grow, and hopefully through strong parenting throughout their childhood, that is something that they would teach their kids as well."
The Bahamas has the highest HIV adult prevalence in the Caribbean region at 3.1 percent, compared to Cuba which has an HIV prevalence of just 0.1 percent. The Bahamas, however, has had great success over the years in preventing mother-to-child transmission, noted McNeil.
He said that all HIV-positive infants are treated upon identification. In 2010, no babies were born with the disease and in 2011 there was one baby less than a year old with HIV.
"There is a skew towards the teenage years," he said. "Our clinic of 127 patients, [has] 81 [patients that] are teenagers, 13-19. Back in 2003, it was a more even distribution." He said he attributes this to the fact that the children have grown up since 2003. "With very few new kids coming in, that has skewed the clinic in that direction and that is something we really want to see," he said.
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