HIV enters its fifth decade amid a global pandemic

About 300,000 children were infected with HIV in 2020, roughly one child every two minutes, Unicef said in a report on Monday.

In addition to those infected, another 120,000 children — a child every five minutes — died from Aids-related causes last year.

Unicef warned ahead of World Aids Day that a prolonged Covid-19 pandemic was deepening the inequalities that had driven the HIV epidemic, putting vulnerable children, adolescents, pregnant women and breastfeeding mothers at increased risk of missing life-saving HIV prevention and treatment services.

“The HIV epidemic enters its fifth decade amid a global pandemic that has overloaded healthcare systems and constrained access to life-saving services. Meanwhile, rising poverty, mental health issues and abuse are increasing children and women’s risk of infection,” said Unicef executive director Henrietta Fore.

Fore said unless efforts to resolve inequalities driving the HIV epidemic, worsened by Covid-19 were ramped up, more children could be infected with HIV and lose their fight against Aids.

Unicef reported that two in five children living with HIV worldwide did not know their status, and just more than half of children with HIV were receiving antiretroviral treatment (ART).

“Some barriers to adequate access to HIV services are long-standing and familiar, including discrimination and gender inequalities. Lockdowns contributed to increased infection rates due to spikes in gender-based violence, limited access to follow-up care and stockouts of key commodities,” said the report.

It also noted that many countries saw significant disruptions in HIV services due to Covid-19 in early 2020.

“HIV infant testing in high-burden countries declined by 50% to 70%, with new treatment initiations for children under 14 years of age falling by 25% to 50%. Several countries also experienced substantial reductions in health facility deliveries, maternal HIV testing and antiretroviral HIV treatment initiation.”

Though uptake of services rebounded in June 2020, coverage levels remained far below those before Covid-19, and the true extent of the impact remained unknown.

The report warned that in regions heavily burdened by HIV, a prolonged pandemic could further disrupt healthcare services and widen gaps in the global HIV response.

“In 2020, sub-Saharan Africa accounted for 89% of new HIV paediatric infections and 88% of children and adolescents living with HIV worldwide, with adolescent girls six times more likely to be infected with HIV than boys. Some 88% of Aids-related child deaths were in sub-Saharan Africa.”

Despite some progress in the fight against HIV and Aids, children and adolescents continued to be left behind across all regions over the past decade.

“Children orphaned due to Aids make up 10% of all orphans worldwide, but 35% of all orphans live in sub-Saharan Africa.”

Fore said a post-pandemic world must include HIV responses that were evidence-based, people-centred, resilient, sustainable and, above all, equitable.

“To close the gaps, these initiatives must be delivered through a reinforced healthcare system and meaningful engagement of all affected communities, especially the most vulnerable.”

TimesLIVE