Closing the Gaps for Children and Adolescents

At the moment, approximately 1.8 million children under the age of 15 years are living with HIV. Every day, 400 children are newly infected and another 300 die. However, fewer than half of those who need treatment are receiving it. The risk does not diminish as these children grow older – HIV is the second largest cause of adolescent deaths globally and the leading cause of death among adolescents in sub-Saharan Africa.

At the same time, the number of uninfected but HIV exposed children is growing. Children with HIV have cognitive delays and their school attendance and performance is affected. HIV-exposed but uninfected children also perform less well than unaffected children on cognitive measure.[1] Parents who are HIV positive are living longer and having more uninfected children. Though this is good news, it is accompanied by a generation of children growing up in the shadow of HIV. They face a unique set of challenges — among them an increased risk of HIV infection, stigma and discrimination — impacting their development, health, education and ability to earn an income.

Along the continuum of care there are clearly missed chances for children and adolescents – with respect to testing, diagnosis, retention and treatment as well as prevention and improving AIDS-free survival. If we are to achieve global goals including 90-90-90 and Start Free, Stay Free, AIDS Free, we must work rapidly to close these gaps. There are two important actions items to doing so:

• Advocating for integrated programming focused on a wide range of interrelated issues – early childhood development, preventing and responding to violence, household economic strengthening, social and child protection, family strengthening/parenting. We know that HIV stymies progress towards most if not all of the Sustainable Development Goals. Focusing on intersectionality is simply efficient. In addition, funding for HIV, which was inadequate to being with, is now flat lining if not decreasing. This requires us to look elsewhere in order mobilize the necessary resources.
• Understanding that a medical response alone is not enough. There is a wealth of evidence to show that children affected by HIV and AIDS need integrated, holistic support, combining biomedical, economic and social interventions. They need support to address not only their physical but also mental, social and emotional needs in order to realize their full potential.

These are issues Coalition members have been and will continue to discuss at global convenings such as the recent REPSSI Psychosocial Forum and the upcoming AIDS Impact conference. We look forward to meeting with you at an upcoming event to continue this important conversation.

[1] (Sughandi et al. 2013) (Scherr et al, 2014)