As infections increase in women, so do infections in their babies. Babies born with AIDS face a short life, during which they will be acutely ill most of the time. Nearly all will die before reaching two years of age. Most child victims are infected before they were born. Recent studies show that approximately half of all HIV-infected women will pass the virus to their babies while still in the womb or during childbirth. Usually, these women are unaware of their infection when they become pregnant. Small numbers of older children are also infected, mainly through contaminated blood received in transfusions or through skin piercing procedures. Adolescents are affected in small but growing numbers, usually through sexual intercourse.
The risk of contracting HIV perinatally occurs in approximately one-third of pregnancies worldwide, but varies greatly between countries. In the early 1990s: in Kenya the rate of transmission of the virus from mother to child was 48%, heightened by weakened immune systems and the ravages of other diseases; in Europe, the maternal transmission rate was around 13%; in the UK it accounted for 10% of HIV infections, which by 1998 had reduced to 2.2 percent as a result of the use of antiviral drugs in late pregnancy, caesarean sections and mothers avoiding brest feeding.
In 1993, HIV infected babies worldwide totalled one million, and more than half of these already had AIDS. In Central America and the Caribbean, there have been marked increases in infection rates among women of childbearing age, resulting in corresponding rise in perinatal transmission. In 1991, 10,000 children in Latin America had been born with HIV infection. In some African countries, as many as one third of all cases occur in the very young. In some parts of Africa, 25% of urban women of reproductive age are infected with HIV, meaning that approximately one in every ten urban children is being born with the AIDS virus. WHO predicts that infant and child deaths from AIDS may increase child mortality rates by as much as 50% in much of sub-Saharan Africa during the 1990s. In many countries this would wipe out the gains in child survival achieved over the previous two decades.
In 1999, an estimated 570 000 children aged 14 or younger became infected with HIV. Over 90% were babies born to HIV-positive women, who acquired the virus at birth or through their mother's breast milk. Of these, almost nine-tenths were in sub-Saharan Africa.