Current state of response not sufficient to end AIDS among minors: UNICEF

The current state of response is not sufficient to end AIDS among children and adolescents, the UN children's fund (UNICEF) has warned.

Though progress has been made, a UNICEF analysis of official data suggests that without accelerated action, the 2020 "super-fast-track targets" for eliminating HIV transmission in children, reducing new infections in adolescent girls and young women, and for increasing HIV treatment in children (0-14 years) and adolescents (15-19 years) living with HIV will not be met, said a UNICEF report released on Friday to coincide with World AIDS Day.

The prevention of mother-to-child HIV transmission is a big success story, said the report, noting that antiretroviral treatment to improve maternal health and prevent mother-to-child transmission was accessed by three quarters of all pregnant women living with HIV in 2016.

Since 2000, some 2 million new infections in children have been averted -- the vast majority of these (1.6 million) since 2010, said the report.

But the global pace of progress is slowing, it warned. UNICEF projects that if the reduction in new pediatric HIV infections continues at the same rate, there will be 100,000 new infections among children in 2020 alone.

While Eastern and Southern Africa, home to half of new HIV infections in children, had the highest proportion of pregnant women receiving effective antiretrovirals for mother-to-child transmission (88 percent), coverage in West and Central Africa is just 49 percent, accounting for 38 percent of new infections in children and 25 percent of all children living with HIV, said the report.

While pediatric HIV prevention saw great achievements, pediatric HIV testing and treatment is lagging, it said.

In 2016, only 43 percent of HIV-exposed infants were tested within the recommended first two months of life. Similarly, only 43 percent of the 2.1 million children living with HIV around the world received antiretroviral therapy.

Without timely treatment, mortality in children with HIV is very high. There were 120,000 children who died of AIDS-related causes in 2016.

In order to end AIDS in children, the remaining 57 percent of children (1.2 million) who are not on treatment need to be identified and started on lifelong treatment as a matter of urgency, said the report.

On the other front, progress in the prevention of new HIV infections among adolescents and HIV testing and treatment have been unacceptably slow, said the report.

Globally, 2.1 million adolescents aged 10-19 years were living with HIV in 2016, a 30 percent increase from 2005. Between 2010 and 2016, trends in new HIV infections among older adolescents (aged 15-19 years) ranged from a 27 percent increase in Eastern Europe and Central Asia to a 21 percent decline in Eastern and Southern Africa.

Since 2000, there have been 5.7 million new adolescent HIV infections. Taking into account a "youth bulge" in Africa, the most affected region, UNICEF projections estimate that without corrective action, new adolescent infections will increase steadily in the next decade, amounting to a total of 3.5 million new adolescent infections by 2030.

While limited, the available data for adolescents suggest worrisome trends regarding treatment access and AIDS-related deaths.

In 2016, only 41 countries reported disaggregated adolescent treatment data and, among these, median antiretroviral therapy coverage was low, at 36 percent.

Since 2010, AIDS-related deaths among adolescents have decreased by only 5 percent, while AIDS-related deaths among children have been halved.

Preventing new adolescent HIV infections will require bold and innovative programmes, tailored to the specific needs of the local epidemic, said the repot.

Programs should focus on improved combination prevention efforts, including biomedical, behavioural and structural interventions with components such as HIV self-testing, pre-exposure prophylaxis, voluntary medical male circumcision, condoms, harm reduction and interventions to end gender-based violence, said the report.

These interventions must be prioritized for adolescent girls in sub-Saharan Africa and the most-at-risk adolescent population groups in the rest of the world, it added, noting that three in four new HIV infections in adolescents occur in sub-Saharan Africa.

For every five adolescent boys living with HIV, there are seven girls. This gender disparity grows as adolescents enter young adulthood. For every five young men living with HIV, there are 10 young women, it said.