Programme

HIV and AIDS

UNICEF’S vision for an AIDS-free generation is that all children and their families are protected from HIV infection and live free from AIDS.

A mom sits on a stoll and embraces her two kids — UNICEF/UN063446/Schermbrucker

Malawi was among the first countries to provide lifelong treatment for pregnant and breastfeeding women living with HIV, thus reducing the risk of transmission of the virus to their babies. Maria benefited from this provision, and as a result, both of her children were born HIV-negative. Today, as a mentor mother, she shares her experience with other women so they are empowered to start treatment and protect their babies from HIV. Read Maria’s story

The challenge

In the past decade, the world has made remarkable progress in the fight against HIV. Since 2010, 1.4 million new infections in children under five have been averted. Since 2000, the number of children (0-19) newly infected with HIV decreased by 49 per cent.

Achieving an AIDS-free generation is within sight, but still distant. Furthermore, progress has been uneven across regions and populations.

The HIV epidemic continues to have a disproportionate impact on children. Just slightly more than half of children under 15 living with HIV receive treatment, placing them at a high risk of AIDS-related death. Without prompt treatment soon after birth, one-third of children living with HIV will die by age 1, and half by age 2. Treatment coverage among adolescents is equally worrisome. Among 40 countries with available data, about 43 per cent of adolescents aged 10-19 living with HIV received ART in 2017. There is an urgent need to diagnosis and link children and adolescents to treatment in time to save their lives.

Cisse Amimata, three months old is tightly wrapped around her mother.

From 2010 to 2017, access to treatment for pregnant and breastfeeding women living with HIV has increased from 51 to 80 per cent. Still, about 180,000 children under 5 were newly infected, or about 20 an hour.

A mother holds her baby in Billy Village Ngabu.

Just over half of the 1.8 million children under 15 living with HIV in 2017 received ART. Of those who did receive ART, it often arrived too late to save their lives.

A mother and her husband at a hospital in Guiglo, in the West of Côte d'Ivoire.

Of the 250,000 adolescents (ages 15-19) who were newly infected with HIV in 2017, 66 per cent were girls.

In 2017, there were 1.8 million adolescents aged 10-19 living with HIV. New HIV infections among adolescents are projected to decrease by 23 per cent between 2018 and 2030, which is not enough to meet global targets. Rapid population growth in many lower- and middle-income countries has created a rising cohort of adolescents and young adults, and combined with slow progress in HIV prevention in young populations, the epidemic seems far from over. Projections show that at the current rate of HIV incidence, without acceleration of efforts and investment, a total of 2.0 million adolescents could become newly infected with HIV between 2018 and 2030.

Read UNICEF’s latest report

Women: At the Heart of the HIV Response for Children

The situation is particularly dire for adolescent girls and adolescents who are members of key populations. Worldwide, approximately an adolescent girl (15- 19) was infected every three minutes in 2017. Adolescent girls account for nearly two out of every three new HIV infections in the 15-19 age group. Adolescents generally, and adolescent girls and adolescent members of key populations in particular, tend to be the groups at most risk of contracting HIV. They are also least likely to have access to treatment. Key populations refers to men who have sex with men, injecting drug users, sex workers, and adolescents who identify as lesbian, gay, bisexual, transgender or intersex.

UNICEF’s HIV/AIDS programme in brief:

For children to reach their full potential, they must be born free of preventable diseases and remain healthy. When HIV progresses to AIDS, it remains a significant cause of mortality among children, especially in sub-Saharan Africa, and among adolescents worldwide.

UNICEF works to reach the following goals:

Eliminate mother-to-child transmission of HIV (eMTCT)
Close the HIV treatment gap – by reaching more children and adolescents living with HIV with effective treatment
Prevent HIV in adolescents

Queen Ndlovu and her daugther Neo live in Chiawelo, a township in the outskirts of Johannesburg, South Africa.

Queen Ndlovu, 34, enrolled in a programme for the prevention of mother-to-child transmission in Chiawelo, South Africa. She gave birth to Neo, who was twice tested diagnosed HIV free.

Longezo is 3 and living with HIV in Nkhuloawe Village, Malawi.

Longezo, 3, is living with HIV in the village of Nkhuloawe, Malawi. He takes medication daily. His life was saved when Bizwick, this health worker, visited his home.

Young people play an “HIV knowledge” board game.

Young people play a game about HIV knowledge at an event to promote sexual and reproductive health among adolescents. The event was sponsored by the China Centre for Health Education, and supported by UNICEF.

The solution

UNICEF’s HIV response centres on pregnant women, mothers, infants, children and adolescents living with HIV, exposed to HIV or at risk of acquiring HIV.

UNICEF supports governments and communities in their efforts to reduce inequities in HIV service delivery and to address the underlying factors of gender, age and poverty that make people vulnerable to HIV. UNICEF supports governments to deliver services that prevent mother-to-child transmission, test infants early, link children diagnosed with HIV to treatment and care and prevent new HIV infections in adolescents.

To do this, UNICEF implements country-specific priorities and interventions and integrates HIV prevention and treatment with maternal, newborn and child health, nutrition, and early childhood development services. We also strengthen and leverage partnerships to widen the reach and impact of our efforts on the ground.Additionally, UNICEF provides innovation and knowledge leadership to help disseminate evidence on children and AIDS to shape policies and programmes and strengthen data systems to effectively map the trajectory of the HIV epidemic, zero in on gaps in the response, and address social determinants of HIV .

A mother and her daughter, hugging and laughing — UNICEF/UNI182445/Schermbrucker

Increased access to lifelong treatment for pregnant and breastfeeding women has significantly reduced the number of HIV infections among children in the past few years. The Optimizing HIV Treatment Access (OHTA) Initiative, funded by the Governments of Sweden and Norway, supported the scale-up of lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women living with HIV in Côte d’Ivoire, the Democratic Republic of the Congo, Malawi and Uganda. Through the expansion of peer support and community-based models, the OHTA initiative supported women living with HIV to start ART immediately, remain in care and adhere to their medication. In 2016, OHTA helped reach over 34,000 pregnant and breastfeeding women living with HIV on treatment. Read more on this project.

UNICEF provides technical assistance to governments to strengthen paediatric HIV services and to scale up HIV infant testing through innovative point-of-care technology. UNICEF, the Clinton Health Access Initiative (CHAI) and the African Society for Laboratory Medicine, with funding and support from UNITAID, are working to accelerate access to point-of-care (POC) HIV technologies in national diagnostic programmes in 10 countries: Cameroon, the Democratic Republic of Congo, Ethiopia, Kenya, Malawi, Mozambique, Senegal, the United Republic of Tanzania, Uganda, and Zimbabwe. POC HIV technologies provide faster HIV testing results than conventional laboratories. They enable infants infected with HIV to start treatment earlier and help reduce mortality in the early months of their lives. Find out more more information on about this project.

Why are these efforts needed?

To prevent new infections

New HIV infections among adolescents are projected to decline by only 23% by 2030 without an acceleration of efforts and investment. If current trends continue 1.2 million children and adolescents will die from HIV/AIDS between 2018 and 2030, almost 70% of them children under 10.

To treat children before it’s too late

Children aged 0–4 years living with HIV face the highest risk of AIDS-related deaths, compared with all other age groups. Young children are often diagnosed and treated too late.

To reduce gender disparities

In sub-Saharan Africa, nearly three times as many adolescent girls were newly infected with HIV in 2017, compared with adolescent boys (15 to 19 years).

Resources

Children and AIDS Statistical Update 2017

Progress has been made in preventing HIV infection in children. But a UNICEF analysis of UNAIDS data suggests that without accelerated action, the super-fast-track targets for eliminating HIV transmission in children, reducing new infections in adolescent girls and young women, and increasing treatment in children and adolescents living with HIV by 2020 will not be met.

UNICEF: Working to End AIDS for Every Child

UNICEF’s response to HIV in children and adolescents is adapting to address ongoing challenges while remaining true to its overarching principles of equity and human rights. The HIV response is a cross-cutting priority implicit in several SDGs including healthy lives (SDG3), ending poverty (SDG1), education (SDG4), gender equality (SDG5) and reducing inequality (SDG10). In its Strategic Plan 2018–2021, UNICEF’s core objectives are: ‘Finishing the job’ of eliminating mother-to-child transmission Seeking opportunities to prevent HIV in adolescents and young women Timely initiation and retention of children and adolescents in treatment and care

Step Up the Pace: Towards an AIDS-free generation in West and Central Africa

The West and Central Africa region has one of the world’s highest HIV burdens among children and adolescents. 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 ‘Three Frees’ targets for ending AIDS among children, adolescents and young women by 2020.

For Every Child, End AIDS: Seventh Stocktaking Report

In recent years, the number of people accessing life-saving drugs has soared, yet children and adolescents have not equally benefited from the scale-up of treatment. Global progress toward curbing the HIV epidemic has been uneven, and children have been left behind. This report outlines the remaining challenges related to children and AIDS at each stage of life and proposes strategies to control the epidemic.

Addressing the Global HIV Epidemic Among Pregnant Women, Mothers, Children and Adolescents: UNICEF’s Global HIV Response 2018–2021

UNICEF has long been at the heart of global efforts to put the HIV epidemic into an irreversible and rapid retreat. Under the Strategic Plan for 2018–2021, UNICEF will continue to align its HIV-related commitments to global goals and targets and frameworks. UNICEF’s Global HIV Response 2018–2021 document describes the differentiated approaches that will be applied to tailor strategies to the distinct epidemiological, political and sociocultural contexts in which we work.

Community-facility linkages to support the scale up of lifelong treatment for pregnant and breastfeeding women living with HIV: a conceptual framework, compendium of promising practices and key operational considerations

This review, commissioned by the OHTA Initiative, examines the literature and programme experience on community engagement and community-facility linkages for PMTCT programmes to promote the successful uptake of PMTCT services and retention in lifelong ART by women during pregnancy or breastfeeding. It also puts forward operational considerations for the practical application of this evidence to guide programme strategy and implementation.

Point of care HIV diagnostics: bringing faster results for early and more effective treatment

This technical brief describes the 'Accelerating Access and Integration of Innovative Point-of-Care HIV Technologies in National Diagnostics Programs' project implemented in 10 countries by UNICEF in partnership with the Clinton Health Access Initiative (CHAI) and the African Society for Laboratory Medicine (ASLM), with funding and support from UNITAID. Point-of-care HIV technologies provide faster HIV testing results than conventional laboratories. They enable infants infected with HIV to start treatment earlier and help to reduce mortality in the early months of their lives.

All In to End the Adolescent AIDS Epidemic: A Progress Report

This report of the All In initiative showcases the significant contributions of many partners to research, innovations, community mobilization, programmes and policy actions aimed at ending the AIDS epidemic in adolescents.

Children and AIDS Learning Collaborative

The Children and AIDS website provides a wide range of resources, videos and scientific articles, offering users the latest and most up-to-date information on HIV.

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