- About 160,000 new HIV infections among children aged 0-14 occurred in 2016, dramatically declining from 300,000 in 2010.
Progress in reducing mother-to-child transmission of HIV has been dramatic since the introduction in 2011 of the ‘Global Plan towards the Elimination of New HIV Infections among Children, and Keeping their Mothers Alive’ – largely because of increased access to PMTCT-related services and increased number of pregnant women living with HIV being initiated on lifelong antiretroviral medicines. But it has not been fast enough to reach the 2020 targets set by UNAIDS and partners as part of the Super-Fast-Track Framework to end AIDS. Acceleration of treatment for all pregnant and breastfeeding women living with HIV is still needed to achieve elimination of new infections among children and halve HIV-related deaths among pregnant women and new mothers.
MORE PREGNANT WOMEN THAN EVER BEFORE RECEIVE TREATMENT TO STOP HIV TRANSMISSION TO THEIR CHILDREN
- As a result of higher testing coverage in high HIV burden countries, an increasing number of pregnant women in low- and middle-income countries are being tested for HIV during pregnancy.
- In 2016 76 per cent of pregnant women living with HIV globally were receiving effective antiretroviral medicines for prevention of mother-to-child transmission (PMTCT), up from 47 per cent in 2010. Furthermore, 73% of pregnant women living with HIV were receiving lifelong antiretroviral therapy (ART).
- In 2016 an estimated 1.4 million pregnant women were living with HIV globally.
- Approximately 90 per cent of these women live in sub-Saharan Africa.
Among UNICEF regions, Eastern and Southern Africa has the highest coverage (88 per cent) of effective antiretroviral medicines among pregnant women who are HIV-positive, followed by Latin America and the Caribbean (75 per cent). All other regions have coverage of under 60 per cent: East Asia and the Pacific (54 per cent), West and Central Africa (49 per cent), South Asia (38 per cent), and Middle East and North Africa (37 per cent). PMTCT coverage data for Eastern Europe and Central Asia, North America and Western Europe are not available, although levels are believed to be high.
REGIONAL VARIATIONS EXIST IN ACCESS TO ANTIRETROVIRAL TREATMENT FOR PREGNANT AND BREASTFEEDING WOMEN
- Access to antiretroviral treatment for pregnant women ranges from 88 per cent in Eastern and Southern Africa to 37 per cent in Middle East and North Africa.
Expanding HIV testing and counselling among pregnant women is critical for identifying those in need of follow-up care and increasing coverage of subsequent interventions that can prevent mother-to-child transmission, as well as provide care and treatment to the mother.
As per current guidance from the World Health Organization (WHO), transmission of the virus from mother to child can be significantly reduced if lifelong antiretroviral treatment is administered according to the WHO guidelines. About 90 per cent of HIV infections in infants and children are passed on from their mothers during pregnancy, delivery or breastfeeding.
Without any intervention, between 15 per cent and 45 per cent of babies born to HIV-positive mothers are likely to become infected. And half of all infants infected with HIV are likely to die before their second birthday if they do not receive treatment.
Reducing HIV transmission from mother to child requires a range of interventions, beginning with voluntary and confidential counselling and testing for the virus. This should be followed by lifelong antiretroviral treatment for pregnant women with HIV and the administration of antiretroviral drugs to their newborns as a preventive measure, as well as safe delivery practices and retention of the mother and infant into long-term care and treatment.
The critical strategies through which elimination of new infections among children and keeping mothers alive can be achieved include: knowledge of HIV status, initiation and retention on antiretroviral treatment with attainment of viral suppression.
WHO guidelines recommend that all infants born to HIV-positive mothers should receive antiretroviral drugs preventively. Data show that the use of services related to the prevention of mother-to-child transmission of HIV is expanding. Poor service delivery in the post-partum period with significant low rates of maternal retention, populations living in hard-to-reach areas, aggravated by weak health systems, and the fear, stigma and denial that continue to discourage women from being tested for HIV are significant barriers to wider uptake of services.
For information on UNICEF’s programme and policy work on HIV and AIDS, click here.
Though progress has been made in preventing HIV infection in children, a UNICEF analysis of UNAIDS 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 and adolescents living with HIV will not be met.
Children are still dying of AIDS-related causes. Children living with HIV (aged 0–4) face the highest risk of AIDS-related death compared to all other age groups. The AIDS-response must focus on solutions for this extremely vulnerable population. Preventing new infections, but also testing and starting treatment early are the best ways to end AIDS among the youngest children. In an age when the tools and knowledge are at hand to prevent and treat HIV in children, new infections and deaths among this age group reflect a collective failure to prioritise children.
At the turn of the century, and the beginning of the Millennium Development Goals, an HIV diagnosis was equivalent to a death sentence for most children and their families in low-income countries. But now, an early diagnosis paired with treatment and care can ensure long healthy lives, regardless of location, and can help prevent transmission of HIV to others. Since 2000, 30 million new infections were prevented, nearly 8 million deaths averted, and 15 million people living with HIV are now receiving treatment.
GLOBAL AIDS RESPONSE PROGRESS REPORTING/UNIVERSAL ACCESS
In an effort to harmonize data collection and minimize the reporting burden on countries, UNAIDS, WHO and UNICEF have developed a joint reporting tool. The tool, which has been translated into several UN languages, combines the Global AIDS Response Progress Reporting and Universal Access reporting on the health sector response to HIV/AIDS. Countries that have not yet begun using the tool are advised to download the latest version. Accompanying guidelines support countries in using the tool and provide detailed descriptions of the indicators used.
- For more information, click here
- For Global AIDS Monitoring reporting guidelines, click here
- To view the latest version of the reporting tool, click here
- To view a list of indicators, click here
SPECTRUM/EPP ESTIMATE MODELLING
UNAIDS, WHO and UNICEF are using Avenir Health’s modelling software, Spectrum/EPP, to generate estimates, which support policy decisions concerning public health. Spectrum includes modules for HIV estimates and projectors.
NATIONALLY REPRESENTATIVE SURVEYS
Multiple Indicator Cluster Surveys (MICS), Demographic and Health Surveys (DHS), AIDS Indicator Surveys (AIS), reproductive health surveys, sexual behaviour surveys and other nationally representative surveys are currently used to collect data on HIV and AIDS.