Toward an AIDS-Free Generation
By Joy Cunningham, FHI 360 Technical Advisor, and Kate Plourde, FHI 360 Technical Officer
Today’s generation of young people has never known a world without HIV. Yet, according to a new report released by UNICEF, Children and AIDS: Sixth Stocktaking Report 2013, the promise is in reach of a world where no child is born with HIV and all children remain uninfected through adolescence. In the 33 years since the first HIV diagnosis, we have both seen the devastating impact of the disease and made impressive progress in HIV prevention and care.
The introduction of lifesaving antiretroviral (ARV) drugs has reduced mother-to-child transmission of HIV and increased life expectancy among perinatally infected infants. The rate of HIV infection among children is rapidly decreasing; since 2009, new HIV infections among children younger than 15 years of age have declined by 35 percent. Despite the enormous progress, much more must be done, especially for adolescents, before we are able to achieve an AIDS-free generation.
According to the report, an estimated 2.1 million adolescents were living with HIV at the end of 2012. Although the overall number of global AIDS-related deaths for all ages declined by 30 percent between 2005 and 2012, AIDS-related deaths among adolescents increased by 50 percent during the same time period. Girls are disproportionately affected. In 2012, an estimated two-thirds of all new HIV infections among adolescents ages 15–19 occurred among girls. In Gabon, Sierra Leone and South Africa, girls accounted for more than 80 percent of all new infections among adolescents. Adolescent key affected populations — injecting drug users, men who have sex with men and individuals who trade or sell sex — are also extremely vulnerable. In Asia and the Pacific, more than 95 percent of new HIV infections occur among this population. This group of adolescents faces particular barriers to accessing services because of social stigma, violence and laws that criminalize risky behaviors.
As HIV infections among adolescents continue to rise and more children living with HIV are surviving into adolescence, the unique needs of adolescents living with HIV require much more attention. Data from the stocktaking report suggests that HIV counseling and testing rates are low among adolescents. As a result, many young people are unaware of their HIV status. Furthermore, few adolescents who are aware of their status have access to ARVs. Research demonstrates that adolescents living with HIV have poorer treatment outcomes than adults because of a multitude of challenges, including lack of youth-friendly services and gaps in the transition from pediatric to adult care. Adolescents living with HIV also need psychosocial support, education in sexual and reproductive health and family planning, and information about secondary infection and preventing transmission.
“As the international community reflects on the gains made in the first decade of life … it cannot continue to neglect the crucial second decade of life.”
— Children and AIDS: Sixth Stocktaking Report
The sixth stocktaking report outlines a clear need to address the gaps in HIV prevention and care faced by young people and provides much-needed global attention to this often overlooked population. It is inspiring and motivating to think that an AIDS-free generation is within reach.
Stocktaking reports on children and AIDS are the flagship publications of the Unite for Children, Unite against AIDS campaign. The United Nations Children’s Fund (UNICEF) leads the development of these publications as part of its commitment to the Joint United Nations Programme on HIV/AIDS (UNAIDS), in collaboration with the 10 other UNAIDS co-sponsors.