Born Free Is Possible: Why No Child Should Begin Life With HIV
Shobha Shukla
In 2025, no child should be born with HIV, syphilis or hepatitis B. The science exists. The tools are proven. What remains is reaching the people whom the system still fails.
In an ideal world, every pregnant woman would access quality maternal care, every child would be born free of preventable infections, and everyone living with HIV would enjoy a healthy, normal life.
Science and evidence-based tools to prevent vertical transmission already make this achievable.
Yet, as 2025 draws to a close, social inequities, stigma, poverty and fragile health access continue to leave too many behind.
A child born into silence
Baba (name changed) is a four-year-old orphan living with HIV in Uttar Pradesh, India.
His parents were migrant workers who lived in Mumbai and briefly worked in Saudi Arabia. Both later tested HIV-positive and began antiretroviral therapy, but their treatment was disrupted. Their health declined rapidly, compounded by tuberculosis in Baba’s mother.
The couple never disclosed their HIV status to family members. When Baba’s mother became pregnant, she did not access institutional delivery. Baba was born at home. Shortly after his birth, both parents died.
According to India’s National Family Health Survey (NFHS-5), institutional delivery in Uttar Pradesh stands at 83.4 per cent, yet gaps remain for the most vulnerable.
From illness to intervention
Baba’s persistent ill-health and delayed development alarmed his caregivers, his aunt and grandmother.
Help arrived during routine door-to-door outreach by Sarojini, a trained community health worker with Humana People to People India.
She counselled the family and linked them to government health services. Baba tested negative for TB but positive for HIV at a tertiary hospital in Lucknow.
With counselling and reassurance, treatment began immediately.
Sarojini’s role did not end there. She ensured treatment adherence, accompanied the family for follow-up visits and addressed challenges as they arose.
Care that goes beyond pills
Initially, Baba struggled with multiple crushed HIV medications. Vomiting and refusal were frequent.
Later, a once-daily fixed-dose combination transformed adherence and eased caregiving.
After starting HIV treatment, Baba also received TB preventive therapy. Today, his viral load remains undetectable, a clear sign that treatment is working and that HIV is untransmittable.
He now attends an Anganwadi centre, benefiting from nutrition, early education and routine health checks. His HIV status remains confidential.
Why frontline workers matter
Sarojini is part of India’s National AIDS Control Organisation (NACO) Link Workers Scheme, implemented by Humana People to People India across 100 villages in Lucknow.
Each trained cluster link worker supports multiple villages, screens high-risk populations for HIV, syphilis and TB, and connects them to care and social welfare services.
Health education, stigma reduction, condom promotion and community engagement, including street plays and village meetings, are central to their work.
Rethink, rebuild, rise
As the world looks ahead to AIDS 2026 in Rio de Janeiro, the message is clear: ending AIDS by 2030 requires systems that truly put people first.
No child should be born with HIV or other preventable infections.
The science is ready. Progress now depends on equity, access and sustained political and community commitment, especially for those most underserved.
Shobha Shukla – CNS (Citizen News Service)
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