An estimated 36.7 million people were living with HIV worldwide in 2016. Of these, 2.1 million were children under 15 years of age and about 18.8 million were women and girls. Each day approximately 5,000 people were newly infected with HIV and approximately 2,800 people died from AIDS, mostly because of inadequate access to HIV prevention care and treatment services. However, new HIV infections among children are declining rapidly – approximately 66% since 2000 – due to scaled-up efforts to prevent mother-to-child transmission.
As of 2016 roughly 16.5 million children under the age of 18 had lost one or both parents to AIDS. Millions more have been affected by the epidemic through a heightened risk of poverty, homelessness, school dropout, discrimination and loss of opportunities. These hardships include prolonged illness and death. Of the estimated 1.0 million people who died of AIDS-related illnesses in 2016, 120,000 of them were children under 15 years of age.
In 2016 around 160,000 children were newly infected with HIV, bringing the total number of children under age 15 living with HIV to 2.1 million. Nearly 90 per cent of these children live in sub-Saharan Africa. One bright spot on the global horizon is the rapid decline of approximately 66% in new HIV infections among children (aged 0-14) since 2000 due to stepped-up efforts to prevent mother-to-child transmission of HIV. However, the number of new infections among adolescents (aged 15-19) has declined at a far slower rate.
An estimated 140,000 children and adolescents died from AIDS-related causes in 2016. About 62% of these preventable deaths occurred among children under 10 years old. The number of AIDS-related deaths among children has declined rapidly since 2000, while the number of AIDS-related deaths among those aged 10-19 has more than doubled.
Sub-Saharan Africa, particularly Southern Africa, remains the region most heavily affected by the epidemic. In 2016 sub-Saharan Africa accounted for approximately 66 per cent of people of all ages living with HIV, 89 per cent of children living with HIV and 85 per cent of adolescents living with HIV worldwide. The spread of HIV in sub-Saharan Africa is mostly through heterosexual relationships, both in the context of transactional and commercial sex and in longer-term relationships, including marriage. In addition, infants born to mothers living with HIV are at risk of becoming infected.
In most other regions of the world HIV disproportionately affects persons who inject drugs, men who have sex with men and sex workers. The epidemic is evolving, however, and transmission patterns are changing throughout the world. In Eastern Europe and Central Asia, HIV epidemics that were once distinguished largely by transmission among persons who inject drugs are now increasingly characterized by significant sexual transmission. In parts of Asia, HIV is transmitted more and more among heterosexual couples. In Asia as a whole, HIV epidemics have long been concentrated in persons who inject drugs, sex workers and their clients, and men who have sex with men. Now, infections are steadily spreading into lower-risk populations through transmission to the sexual partners of those most at risk. For information on UNICEF’s programme and policy work on HIV and AIDS, click here.
The West and Central Africa region has one of the world’s highest HIV burdens among children and adolescents, second only to that of Eastern and Southern Africa. Yet, due to its lower HIV prevalence rate, the epidemic has received less attention than in other regions. This report takes stock of the progress and shortfalls in the HIV response in West and Central Africa, offers an analysis of the challenges that continue to slow progress, and outlines several strategic directions to achieve the targets defined in the ‘Three Frees’ framework for ending AIDS among children, adolescents and young women by 2020.
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.
Childhood vulnerability cuts across all development programming and planning, including the sectors of HIV and AIDS, education, health, child protection and social protection. Understanding indicators of childhood vulnerability in general and to HIV in particular, could help practitioners identify vulnerable children more accurately and spend money accordingly.
An AIDS-free generation means a generation in which all children are born free of HIV and remain so for the first two decades of life, from birth through adolescence.
Global AIDS monitoring 2018
In order to monitor the HIV response and progress towards achieving global goals, countries submit national and subnational data on a host of indicators to the Global AIDS Monitoring (GAM) system. Annual submissions are reviewed and validated. Data consist of programmatic data for HIV prevention, testing and treatment. Other indicators require data from population-based surveys and surveys focused on key populations at risk of HIV infection.
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Spectrum/EPP estimate modelling
UNAIDS, WHO and UNICEF are using the Futures Institute’s modelling software, Spectrum/EPP, to generate estimates, which support policy decisions concerning public health. Spectrum includes modules for HIV estimates and projections.
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.