overview of the hiv epidemic among infants, children, adolescents...

Overview of the HIV epidemic among

Infants, Children, Adolescents and

Women

UNAIDS, Geneva

Mary Mahy

Team Lead, Epidemiology

No personal conflicts of interest

Nothing to disclose

… very little change

• Coverage levels of have not increased in the past 2

years (among pregnant women or children)

• …. despite improved understanding of what works

• We have more confidence in the data– Country programme data being scrutinized – data quality assessments

– Using HIV prevalence data from routine testing at ANC

– Consistent with nationally representative survey estimates

– Improved estimate of HIV prevalence for Nigeria

– All historical estimates are updated with improved estimates

Progress in reaching

pregnant women with ARVs

Coverage of women receiving ARVs to prevent vertical transmission

Source: UNAIDS 2019 estimates and Global AIDS Monitoring 2019

Decline in births among

young women (15-24 years) living with HIV

-15%

+3%

Source: UNAIDS 2019 estimates

63% decline in new child HIV infections

since 2000, missed the 2018 target

Number of new child infections, globally, 2000-2018


160,000 in 2018

40,000 in 2018

Stacked bar to identify gaps in PMTCT

Source: Special analysis of UNAIDS 2019 estimates

Num

ber

of new

child

infe

ctions

Missed the 2018 ART target for

children (0-14 years)


54% of children living with HIV

are receiving treatment

Children living with HIV receiving ART, by region, 2010-2018


Global ART

coverage: 54%

among children

62% among adults

82% among

pregnant women

Treatment cascades show particularly

challenges with viral load suppressionPercentage of children living with HIV who are diagnosed, receiving ART and

have suppressed viral load, and PHIA results countries with available data, 2018

Perc

ent


2 out of 3 children living with HIV are in

eastern southern Africa, 50% in 6 countries


1.7 million children (0-14 years) living with HIV,

growing proportion 10-14 years

Number of children living with HIV by age group, globally, 2000-2018


Distribution of children and adolescents by age

varies – depending on timing of PMTCT roll out


Decline in AIDS-related deaths

among children and adolescents


Roughly 15 million children (<15 years)

exposed to HIV but uninfected

- In countries with high

prevalence among

pregnant women the

proportion of HEU

children is high

- 20-30% of children in

Botswana, Eswatini,

Lesotho and South

Africa

Number of children HIV exposed and uninfected, globally, 2000-2018


Increasing proportion of children

are HIV and ART exposed

Number of children HIV exposed and uninfected and HIV and

ART exposed and uninfected, globally, 2000-2018


Conclusions

• Close the tap – support countries to use stacked bar to focus

PMTCT programmes, including prevention during pregnancy

and breastfeeding, retention on treatment

• Identifying children with HIV, consider the age groups to target –

different testing modalities and regimens

• Lower ART coverage among children than adults …

– And among those on ART children have lower rates of viral suppression

• Continued challenge of reporting data on adolescents on ART

• Monitor the outcomes of HIV exposed and uninfected children

over time

Acknowledgements

• Country HIV estimates teams

• John Stover, Avenir Health

• Martina Penazzato, WHO

• Global partners (UNICEF, WHO, CDC, GFATM, EGPAF) for

collaboration validating these data

Definition of regions for stacked bar analysis (slide 7)

Eastern Africa: Ethiopia, Kenya, Uganda, United Republic of Tanzania

Southern Africa: Angola, Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia, Zimbabwe

Western and central Africa: Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ghana, Nigeria

Further information

• Aidsinfo.unaids.org

• Data available by country and age group

• Launch of Start Free, Stay Free, AIDS Free –

– Monday, 22 July 7:00 - 8:30, breakfast will be served

– Main conference centre - Room: Palacio de Valparaíso 1

overview of the hiv epidemic among infants, children, adolescents...

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