UNAIDS to Focus on Eradicating AIDS in Youth Even as Incidence Drops Worldwide
Mon, November 29, 2021

UNAIDS to Focus on Eradicating AIDS in Youth Even as Incidence Drops Worldwide

United Nations officials have called for stronger prevention, treatment, and care measures to help curb and eradicate HIV/AIDS cases among children and youth / Photo by: Sergey Pazharski via 123RF

 

United Nations officials have called for stronger prevention, treatment, and care measures to help curb and eradicate HIV/AIDS cases among children and youth. The call comes as the number of children living with HIV (CLHIV) drops worldwide, thanks to the successful prevention of mother-to-child transmission programs. UNAIDS highlighted the "failures" of response to HIV/AIDS in certain areas as well as "game-changing interventions" to address these shortcomings. 

 

Ending the HIV/AIDS Epidemic in Youth

In 2018, global estimates show 1.7 million children below 15 years old are living with HIV, with nearly 63% in sub-Saharan Africa. This number continues to decline as interventions successfully curb further transmissions from HIV-positive mothers. Another reason is that infected children are moving into the adult cohort group, which also attributes to the decline in the number of deaths due to the cell-killing disease. New infections among children also decreased by 41% while deaths due to HIV/AIDS dropped by 51%, according to a study published in the online journal AIDS.

However, the World Health Organization maintained that the global transmission rate remains high in 2018 with 12.7%—indicating the importance of testing all HIV-exposed infants within two months after birth and immediately deliver the test results.

An estimated 21.7 million people living with HIV received antiretroviral therapy (ART) for HIV. A study in the journal CELL said that out of that number, only 941,000 are CLHIV—merely 52% coverage compared to the 59% observed in the adult population.

As such, the UNAIDS declares that diagnosis and treatment among CLHIV remain a challenge even with the significant decline in incidence and prevalence of HIV among children. This is partly because HIV treatment services are "essentially designed for adults with limited consideration to meet the specific needs of [the] younger individual."

Failures on HIV/AIDS Response

During a conference last month, officials from the UNAIDS Program Coordinating Board (PCB) gathered to discuss the challenges that CLHIV and youths at risk of HIV face. A key focus was the halted progress on preventing mother-to-child HIV transmission (PMTCT). Places where high levels of ART initiation still see more women stopping their treatment during pregnancy and breastfeeding while many others are unaware that they've contracted the disease during this period, according to a press release.

Infected children are also missing early infant diagnosis (EID), which would've helped in wiping out the time gap between diagnosis and treatment of HIV. The stigma surrounding the disease, especially in their own family, and the psychological trauma it causes remain a challenge among HIV-positive youth.

But the most pressing of them all is possibly society's insufficient attention to CLHIV.

"Civil society decried the insufficient attention given to children, with PCB nongovernmental organization delegation members calling on UNAIDS and cosponsors to “wake up” to the mortal danger posed to millions of children by the shortcomings of the AIDS response," the press release notes.

During a conference last month, officials from the UNAIDS Program Coordinating Board (PCB) gathered to discuss the challenges that CLHIV and youths at risk of HIV face / Photo by: Thorkild Tylleskar via Wikimedia Commons


Reducing the impact of HIV/AIDS in children

UNAIDS board officials stress the need to ramp up pediatric prevention, treatment, and care for HIV "not just as a medical imperative, but as a matter of human rights."

To maintain PMTCT, sessions panelists at the conference suggest scaling up improved treatment options for HIV and HIV-related infections across the lifecycle. Angela Mushavi, national PMTCT/pediatric HIV care and treatment coordinator of Zimbabwe's Ministry of Health, suggested using data to optimize PMTCT and deliver health services to children in need. Along with this is promptly finding and identifying CLHIV through proactive, multi-faceted efforts such as strengthened EID, innovating point-of-care testing technologies, family or index training, and integrating diverse settings testing.

Preventing new infections can also be done by empowering the youth through "comprehensive sexuality education, keeping girls in school and making schools safe, and preventing gender-based violence," Macanjana Motsa, undersecretary of the Ministry of Education and Training in Eswatini, said in the conference.

Peer groups and addressing innovation inequities concerning children and HIV can help dismantle the stigma around the disease while also overcoming the trauma stemming from the stigma.

Working Together

To successfully reduce the impact of HIV/AIDS among children and the youth, UNAIDS calls for the "unique collaborative framework" known as the Vatican Initiative. This initiative will bring together major stakeholders to work together in accelerating the development and uptake of antiretroviral (ARVs) HIV medication for children.

It's this kind of initiative that led pharmaceutical company ViiV Healthcare to move fast on developing much-needed pediatric formulations of an ARV known as dolutegravir. The drug not only treats HIV/AIDS, but it is also used to prevent infection after potential exposure.

UNAIDS also emphasized the need to adapt key solutions including:

• Engage in multiple government and private organizations as partners to leverage ongoing efforts.
• Tackle multiple programmatic components to ensure impact.
• Strengthen HIV services as innovations are introduced—taking innovations to scale will require sustained effort.
• Regularly review for quality improvement.
• Enable and support country action.

The fight against HIV/AIDS has thankfully made a lot of headway since the disease broke into the global consciousness. But it’s still a long way to go, especially when it comes to the cases of innocent babies and young children. It will definitely take a more concerted effort to save them.

To successfully reduce the impact of HIV/AIDS among children and the youth, UNAIDS calls for the "unique collaborative framework" known as the Vatican Initiative / Photo by: rawpixel via 123RF