Quick fact:
- Of the 1.54 million (1.20 million to 2.11 million) children aged 0 to 14 living with HIV globally, only 57 (44 to 78) percent were receiving antiretroviral therapy (ART) vital in 2022.
Globally, children under the age of 15 account for approximately 4 percent of all people living with HIV, 10 percent of new HIV infections, and 13 percent of all AIDS-related deaths. Children under the age of one are among the most vulnerable to HIV. Evidence shows that early initiation of antiretroviral therapy in HIV-positive infants can save lives; However, coverage of critical interventions for children remains too low. Due to the slow progress reported in improving access to treatment for children living with HIV, the Treatment goals 90-90-90, which called for 90 percent of people living with HIV to know their status, 90 percent of those who know their status to be on treatment, and 90 percent of people on treatment to be on suppressed and maintained viral treatment, did not not been respected. However, the goal has been renewed to achieve the 95-95-95 targets by 2025, notably with the launch of the Global Alliance to End Childhood AIDS.
Renewed attention has been called for to strategically target more decentralized diagnostics and clinical management for children exposed to and living with HIV, as well as integration with maternal, child and adolescent services. in establishments and within communities. The 2025 goals emphasize the need to remove societal and legal barriers to service delivery, and recognize that the HIV response is essential as part of a broader effort to realize the right to health and other human rights and other goals of the 2030 Agenda for Sustainable Development.
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HIV burden among children
Quick fact:
- Of the 1.54 million (1.20 to 2.11 million) children under 15 living with HIV, 87 percent live in sub-Saharan Africa.
In 2022, 68 (57-88) percent of HIV-exposed infants were tested for HIV within two months of birth globally. International guidelines indicate that immediate antiretroviral treatment is crucial if HIV infection is detected in a child under 5 years of age. In reality, most children entering treatment programs are older, with only 20 percent of all children under 15 on antiretroviral therapy being under 5 in 2022.
An estimated 1.54 million (1.20 to 2.11 million) children under the age of 15 were living with HIV in 2022. In 2022, 130,000 (90,000 to 210,000) children were newly infected with HIV. HIV, mainly through transmission of the virus from their mother during pregnancy, childbirth or while breastfeeding.
In 2022, an estimated 84,000 (56,000 to 120,000) children under the age of 15 will have died from AIDS-related causes worldwide. The vast majority of these deaths could have been avoided, either through antibiotic treatment of opportunistic infections and/or through antiretroviral treatment.
Progress has been made in antiretroviral coverage for children living with HIV
Fast facts:
- In 2022, approximately 880,000 children under the age of 15 were receiving antiretroviral treatment (ART) globally, compared to approximately 430,000 in 2010. However, it should be noted that the number of children under the age of 15 accessing ART decreased by 30,000 between 2020 and 2022.
- This means that just over half of children under 15 living with HIV receive ART (57 (44-78) percent).
In 2022, coverage of eligible children under 15 receiving ART varied widely, from less than 7 percent in some countries to more than 95 percent in others. Regionally, ART coverage for children ranged from 37 (29-45) percent in West and Central Africa to 63 (49-92) percent in South Asia. Coverage data for Eastern Europe and Central Asia, North America and Western Europe are not available.
Despite some progress in antiretroviral treatment coverage for children living with HIV, there are alarming proportions of children who do not know their HIV status and are therefore being left behind in the response. Globally, 37 percent of children living with HIV do not know their status, with the lowest proportion knowing their status being 37 percent in West and Central Africa and the highest being 37 percent in West and Central Africa. 55 percent in the Middle East and North Africa.
Even among children who know their HIV status, a worrying proportion of children are either those not on ART or those on ART whose viral load is not suppressed. Concerted efforts are needed to ensure that these children are not left behind and are placed in care.
Early diagnosis and prompt initiation of treatment are particularly essential in the case of infants. The South African Children with HIV Early Antiretroviral Therapy study demonstrated a 76 percent reduction in mortality when treatment was initiated during the first 12 weeks of life in infants who tested positive for HIV.
Countries have made some progress in expanding access to early infant HIV testing services, but testing rates remain low. The revised WHO treatment guidelines recommend that infants, if exposed to HIV, be tested before 4 to 6 weeks and 9 months of age using a virological test, and when the child stop breastfeeding, with a rapid antibody test. People who test positive should start antiretroviral treatment immediately after diagnosis. With progress in expanding access to infant HIV testing services and antiretroviral treatment for children, we are seeing these children survive and age from childhood into adolescence. In 2022, nearly 140,000 children will reach the age of 15 worldwide. More than 65 percent of these children who reach the age of 15 are in the most affected regions of eastern and southern Africa, followed by about 20 percent in west and central Africa. However, the progress made in the early 2000s has started to plateau in recent years.
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