Challenges in pediatric HIV/AIDS care: nursing roles in primary and clinical settings
DOI:
https://doi.org/10.14456/taj.2026.16Keywords:
challenges, children living with HIV/AIDS, pediatric nursing, primary and clinical careAbstract
Children living with HIV/AIDS continue to constitute a significant global public health concern despite substantial advances in access to antiretroviral therapy (ART) and the prevention of mother-to-child transmission. A considerable number of children living with HIV still experience growth delay, malnutrition, opportunistic infections, and developmental delays. In addition, psychosocial consequences, including depression, anxiety, stigma, and discrimination, remain major impediments to quality of life and educational opportunities. This review aims to examine four major challenges in the care of children living with HIV/AIDS: (1) poor adherence to ART due to poor palatability, adverse drug effects, and dependence on caregivers; (2) nutritional deficiencies; (3) psychosocial impacts related to family loss and social stigma; and (4) limitations within health service systems, particularly in rural and low-income countries. A holistic nursing approach is required, encompassing comprehensive health and developmental assessment, promotion of consistent medication adherence, management of adverse reactions, psychosocial and family support, and health education. The integration of primary health care with multidisciplinary teams, community networks, and continuous follow-up systems has been recognized as crucial for enhancing treatment outcomes and minimizing long-term consequences. In summary, pediatric nurses are well-positioned to play a strategic role in coordinating HIV care. The development of accessible, comprehensive, and stigma-free health services is imperative to enhance the quality of life of children living with HIV.
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References
Joint United Nations Programme on HIV/AIDS. In danger: UNAIDS global AIDS update 2022 [Internet]. 2022 [cited 2025 Sep 7]. Available from: https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update
World Health Organization. HIV and AIDS [Internet]. 2021 [cited 2025 Sep 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids
Laughton B, Cornell M, Grove D, Kidd M, Springer PE, Dobbels E, et al. Early antiretroviral therapy improves neurodevelopmental outcomes in infants. AIDS. 2012;26(13):1685-90.
Shiau S, Abrams EJ, Arpadi SM, Kuhn L. Early antiretroviral therapy in HIV-infected infants: can it lead to HIV remission? Lancet HIV. 2018;5(5):e250-8.
Obeagu EI, Obeagu GU, Odo EO, Igwe MC, Ugwu OP, Alum EU, et al. Combatting stigma: essential steps in halting HIV spread. IAA J Appl Sci. 2024;11:22-9.
UNICEF. Children, HIV and AIDS: the world today and in 2030 [Internet]. 2018 [cited 2025 Sep 7]. Available from: https://data.unicef.org/resources/children-hiv-and-aids-2030/
Johnson K. HIV and AIDS in Africa [Internet]. 2021 [cited 2025 Oct 5]. Available from: https://doi.org/10.1093/acrefore/9780190277734.013.1005
Bidzha ML, Ngepah N, Greyling T. The impact of antiretroviral treatment and child-focused unconditional cash transfers on child mortality. SSM Popul Health. 2024;26:101671.
UNAIDS. Thailand country factsheet [Internet]. 2023 [cited 2026 Feb 2]. Available from: https://www.unaids.org/en/regionscountries/countries/thailand
World Health Organization Regional Office for South-East Asia. Thailand is first country in Asia to eliminate mother-to-child transmission of HIV and syphilis [Internet]. 2016 [cited 2026 Feb 2]. Available from: https://www.who.int/southeastasia/news/detail/07-06-2016-thailand-is-first-country-in-asia-to-eliminate-mother-to-child-transmission-of-hiv-and-syphilis
Enicker B, Aldous C. Factors associated with in-hospital mortality in HIV-infected children treated for tuberculous meningitis hydrocephalus. Childs Nerv Syst. 2024;40(3):695-705.
Lowenthal ED, Bakeera-Kitaka S, Marukutira T, Chapman J, Goldrath K, Ferrand RA. Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges. Lancet Infect Dis. 2014;14(7):627-39.
Matshepete LP, Makhado L, Mashau NS. Community-based interventions to support HIV and AIDS orphans and vulnerable children (OVC) in Africa: a systematic review. Int J Integr Care. 2025;25(2):5.
Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care. 2024;36(sup1):137-44.
Cisse AM, Laborde-Balen G, Kebe-Fall K, Drame A, Diop H, Diop K, et al. High level of treatment failure and drug resistance to first-line antiretroviral therapies among HIV-infected children receiving decentralized care in Senegal. BMC Pediatr. 2019;19(1):47.
Li X, Zhang R, Da W, Zhou Y, Shen Z, Qiao S. Efficacy of a cluster randomized controlled parental HIV disclosure intervention trial among parents living with HIV in China: evaluation based on the health action process approach. Front Reprod Health. 2025;7:1499481.
Rovaris NS, Galato D, Schuelter-Trevisol F, da Silva J, da Silva Linhar L, Nickel DA, et al. Oral health status and its impact on the quality of life of children and adolescents living with HIV-1. BMC Res Notes. 2014;7(1):478.
Toledo G, Cote HCF, Adler C, Thorne C, Goetghebuer T. Neurological development of children who are HIV-exposed and uninfected. Dev Med Child Neurol. 2021;63(10):1161-70.
Mahajan VK, Dhattarwal N, Mehta KS, Chauhan PS, Sharma A, Sharma RK, et al. Prevalence of anemia among HIV-infected individuals and the associated factors: a single-center, retrospective review of 513 cases. Our Dermatol Online. 2023;14(1):23-8.
Escosa-Garcia L, Sainz T. HIV and ART in children. Front Pediatr. 2022;10:1074684.
Bekker LG, Beyrer C, Mgodi N, Lewin SR, Delany-Moretlwe S, Taiwo B, et al. HIV infection. Nat Rev Dis Primers. 2023;9(1):42.
Kranzer K, Bradley J, Musaazi J, Nyathi M, Gunguwo H, Ndebele W, et al. Loss to follow-up among children and adolescents growing up with HIV infection: age really matters. J Int AIDS Soc. 2017;20(1):21737.
Rego CV, Potterton JL. Motor function, muscle strength and health-related quality of life of children perinatally infected with HIV. S Afr J Physiother. 2022;78(1):1812.
Sandgaard KS, Gkouleli T, Attenborough T, Adams S, Gibbons D, Holm M, et al. The importance of taking ART appropriately in children and adolescents with HIV-1 to reach the highest capacity of immune function later in life. Front Immunol. 2022;13:860316.
Harris J, Thaiprayoon S. Common factors in HIV/AIDS prevention success: lessons from Thailand. BMC Health Serv Res. 2022;22(1):1487.
Lertpiriyasuwat C, Jiamsiri S, Prommali P. Thailand’s commitment to support community-led HIV services. Lancet HIV. 2024;11(3):e141.
