African children are neglected when it comes to HIV treatment: Lancet study

Only 55% of African children living with HIV (including those who were previously undiagnosed) are on antiretroviral therapy and 32.6% have a suppressed viral load, the study says

By Madhumita Paul
Published: Wednesday 16 February 2022
Africa is among the worst-hit due to the four-decade-long AIDS pandemic. Photo: iStock

It has been four decades since the HIV-AIDS pandemic broke out in 1981. Recently, a new, more virulent strain has been discovered in the Netherlands. But the place most affected by the pandemic is Africa, where children, the weakest, continue to be neglected to this day, according to a new study published in The Lancet.

The researchers found 39 per cent of children aged 1-14 years, or 166,000 children across seven African countries, to be living with undiagnosed HIV.

They also found that only 55 per cent of the African children living with HIV (including those who were previously undiagnosed) were on antiretroviral therapy (ART) and 32.6 per cent had a suppressed viral load.

Read: HIV positive children’s treatment in Africa not on par with adults: UN Report

This showed that in sub-Saharan Africa, ART coverage for children still lagged behind that for adults.

The project was conducted by CUNY Graduate School of Public Health and Health Policy assistant professor Chloe Teasdale and colleagues from ICAP (previously International Centre for Aids Care and Treatment Programmes) at Columbia University, both in the United States.

The study provides the first national estimates of the prevalence of undiagnosed HIV in children based on population-level data from sub-Saharan Africa. The findings were published in The Lancet HIV.

A survey was conducted in Eswatini, Lesotho, Malawi, Namibia, Tanzania, Zambia and Zimbabwe from 2015 to 2017. In this survey, 42,248 children aged 1–14 years were included, of whom 594 were living with HIV.

In all countries except Tanzania and Zambia, HIV prevalence was higher among children aged 10–14 years than among children younger than 10 years.

According to the study, two-thirds of undiagnosed children living with HIV across the seven countries had reportedly never been previously tested for HIV and many mothers of children living with HIV were newly identified as HIV-positive.

But some progress has been made. In Malawi, Namibia, Tanzania, and Zambia, for instance, early infant diagnosis coverage increased from less than 50 per cent in 2015 to between 65 per cent (Zambia) and 99 per cent (Namibia) by 2020.

According to UNAIDS, 46 per cent of the world’s 1.7 million children living with HIV were not on treatment in 2020. The majority of children living with HIV are infected via mother-to-child transmission, during pregnancy, childbirth or breastfeeding.

HIV remains a major global public health challenge and the novel coronavirus disease (COVID-19) has added to it. This is especially so in the eastern and southern Africa region — the epicentre of the HIV epidemic, with 800,000 new HIV infections each year, just under half of the global total. 

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