1. HIV/AIDS and Orphaned and Vulnerable Children Jane Subak Kennedy, MSW Outpatient Pediatric Clinic Social Worker Children’s Hospital of Philadelphia Philadelphia, PA, USA Johannesburg, South Africa Wednesday, October 15, 2008 ©2008 National Association of Social Workers. All Rights Reserved. 1

2. 5,500,000 1,200,000 21,000

6. Angela A 16 year old AA female Presents to the clinic because she has missed her menstrual period Evaluation includes testing for STIs, including HIV She consented to HIV testing Pretest counseling

7. Angela Rapid HIV test is positive –Angela waits for the results Angela gets results from practitioner and SW Confirmatory blood test is performed Referral made to Adolescent HIV Program at CHOP for specialty care Angela still comes to clinic for primary care

8. CHOP Adolescent HIV Program Case management Evaluate developmental level Recognize supports Identify barriers to care Home visits by care team Individual and family therapy Support groups Transition to adult care program

9. How Adolescents Get HIV Info Medical clinics School-based programs Health fairs Peer education Media

12. Strategies to prevent perinatal HIV transmission 1.Primary prevention of HIV infection in women 2.Universal voluntary HIV counseling and testing during pregnancy 3.Prophylactic antiviral therapy for mother and newborn 4.Elective C/S delivery 5.Avoidance of breastfeeding

13. AZT regimen During pregnancy –Begin treatment at 14-34 weeks gestation –five times a day orally During labor –Administer IV throughout labor and delivery Newborn –Begin 6 hrs after birth –Every 6 hrs by mouth –Continue until 6 wks of life