Globally, the annual number of new infections among children (0-14 years) has almost halved since 2010 with a 47% reduction in new HIV cases. Since 1995, an estimated 1.6 million new HIV infections among children have been averted due to the provision of antiretroviral medicines (ARVs) to women living with HIV during pregnancy and breastfeeding. The vast majority of these infections (1.3 million) were averted between 2010 and 2015.
Despite this significant progress, the number of children becoming newly infected with HIV remains unacceptably high. In 2016, 24% of pregnant women living with HIV did not have access to ARVs to prevent transmission to their infants. In the same year, around 160,000 children became infected with HIV; this equates to 438 children a day.
In 2015, in the 21 highest-burden countries, only 54% of children exposed to HIV were tested within the recommended two months. In the following year, an estimated 1.8 million children were living with HIV, but just 43% had access to ARVs. Although treatment coverage has improved since 2010, when just 21% of children living with HIV were on antiretroviral treatment (ART), the current situation means that around half of the children in need do not have access.
The majority of children living with HIV live in Africa, where AIDS remains the leading cause of death among adolescents. Globally, 120,000 children died due to AIDS-related illnesses in 2016. This equates to 328 deaths every day. In fact, children aged 0–4 years living with HIV are more likely to die than any people living with HIV of any other age. This is despite a 62% reduction in AIDS-related deaths among this age group globally, since 2000.
In addition, millions more children are indirectly affected by the impact of the HIV epidemic on their families and communities.
Regular HIV testing, treatment, monitoring and care for children living with HIV can enable them to live long and fulfilling lives. However, a lack of necessary investment and resources for adequate testing, paediatric ARVs and child-friendly prevention programmes mean children continue to suffer the consequences of the epidemic.
Why are children at risk of HIV?
Mother-to-child transmission (MTCT)
The majority of children living with HIV are infected via mother-to-child transmission (MTCT), during pregnancy, childbirth or breastfeeding. This is sometimes referred to as ‘vertical transmission’ or ‘parent-to-child-transmission’
MTCT of HIV can be stopped, as long as expectant mothers have access to preventing mother-to-child transmission (PMTCT) services during pregnancy, delivery and breastfeeding. With funding, trained staff and resources, new infections among many thousands of children could be avoided.
Breastfeeding is now responsible for the majority of MTCT. When formula feeding is not a viable option, women can greatly reduce the risk of transmitting HIV to their child at this stage if they exclusively breastfeed and are on ART. However, in 2013 only 49% of women continued to take ARVs while breastfeeding, compared to 62% of women who took ARVs during pregnancy and delivery. This highlights the urgent need for education about the importance of continuing treatment post-birth.14
Without ART, a third of infants who acquire HIV as a result of MTCT will not reach their first birthday, and half will not reach their second birthday.15
