Globally, the incidence of HIV has decreased, but a new report from UNICEF highlights the ongoing crisis faced by adolescent girls and children in many regions. According to the report, in 2022, 99,000 adolescent girls and children died from AIDS-related causes. The most affected regions are Eastern and Southern Africa, followed by West and Central Africa, East Asia and the Pacific, Latin America and the Caribbean, and South Asia.
Adolescent girls and children in these areas face significant challenges in accessing treatment compared to adults. Despite accounting for only 7% of those living with AIDS, they make up 15% of all deaths. The lack of age-appropriate antiretroviral medication and limited testing options for this age group are major obstacles.
One of the major hurdles in addressing the crisis is the lack of standardized and readily available testing in lower- and middle-income countries. The diagnostic process for young individuals is often cumbersome, further hindering their access to HIV care.
According to UNICEF, only 57% of children aged 0–14 years are receiving retroviral treatment, compared to 77% of older adolescents aged 15–19. Eastern and Southern Africa have the highest number of untreated children. Factors contributing to higher HIV rates among adolescent girls and young women include sexual violence, intimate partner violence, age-disparate relationships, limited access to sexual and reproductive healthcare services, and poor sex education.
Ensuring access to diagnoses and treatment is crucial for reducing childhood HIV-related deaths. The World Health Organization estimates that without better access, 50% of children with HIV will die before the age of 2, and 80% will not live beyond their fifth birthday. More than 90% of childhood HIV infections occur due to transmission from infected mothers during pregnancy, childbirth, or breastfeeding.
While challenges in implementation and resource limitations persist, there is hope on the horizon. The use of dolutegravir (DTG), an integrase inhibitor, has shown promise in trials. DTG can be administered to HIV patients as young as 4 weeks old and has produced promising real-world data among children and adolescents in Eastern and Southern Africa.
It is important to note that treatment remains the best prevention strategy, as it reduces the community viral load and makes transmission unlikely. People in treatment cannot transmit HIV to their partners. Achieving better access to treatment and care for adolescent girls and children is crucial in the global fight against HIV/AIDS.