Achieving an AIDS-free generation is possible if the international community steps up efforts to provide universal access to HIV prevention, treatment, and social protection, according to Children and AIDS: Fifth Stocktaking Report 2010. Attaining this goal, however, depends on reaching the most marginalized members of society.
While children in general have benefited enormously from the substantial progress made in the AIDS responses, there are millions of women and children who have fallen through the cracks due to inequities rooted in gender, economic status, geographical location, education level and social status. Lifting these barriers is crucial to universal access to knowledge, care, protection, and the prevention of mother-to-child transmission (PMTCT) for all women and children.
The World Health Organization (WHO) revised its guidelines earlier this year, to ensure quality PMTCT services for HIV-positive pregnant women and their infants. In low- and middle-income countries, 53 per cent of pregnant women living with HIV received antiretrovirals (ARVs) to prevent mother-to-child transmission in 2009, compared to 45 per cent in 2008. One of the most significant increases occurred in Eastern and Southern Africa, where the proportion jumped ten percentage points, from 58 in 2008 to 68 per cent in 2009.
AIDS is still one of the leading causes of death among women of reproductive age globally and a major cause of maternal mortality in countries with generalized epidemics. In sub-Saharan Africa, 9 per cent of maternal mortality is attributable to HIV and AIDS.
WHO also issued new ARV guidelines for treating infants and children, paving the way for many more children with HIV to be eligible for immediate antiretroviral treatment (ART). In low and middle-income countries, the number of children under the age of 15 who received treatment rose from 275,300 in 2008 to 356,400 in 2009. This increase means that 28 per cent of the 1.27 million children estimated to be in need of ART receive it. Infants are particularly vulnerable to the effects of HIV, which has lent an urgency to the global campaign for early infant diagnosis. While the availability of early infant diagnosis services has increased dramatically in many countries, global coverage still remains low, at only 6 per cent in 2009. Without treatment, about half of the infants infected with HIV die before their second birthday.
In most parts of the world, new HIV infections are steadily falling or stabilizing. In 2001, an estimated 5.7 million young people aged 15–24 were living with HIV. At the end of 2009, that number fell to 5 million. However, in nine countries – all of them in southern Africa – at least 1 in 20 young people is living with HIV.
Young women still shoulder the greater burden of infection, and in many countries women face their greatest risk of infection before age 25. Worldwide, more than 60 per cent of all young people living with HIV are female. In sub-Saharan Africa, that figure is nearly 70 per cent.
Adolescents are still becoming infected with HIV because they have neither the knowledge nor the access to services to protect themselves. Attaining an AIDS-free generation means erasing the inequities that fuel the epidemic and protecting those who continue to fall through the cracks. Social protection initiatives – including cash transfers and efforts to promote access to services – play an important role in breaking the cycle of vulnerability. The report also emphasizes the importance of tailoring education programmes to target the most vulnerable youths – those who are out of school – with information about HIV prevention.