Report reveals inequalities in access to HIV prevention and treatment services for children

July 23, 2021

In the final report from the Start Free, Stay Free, AIDS Free initiative, UNAIDS and partners warn that progress towards ending AIDS among children, adolescents and young women has stalled, and none of the targets for 2020 were met.

The report shows that the total number of children on treatment declined for the first time. It also shows that opportunities to identify infants and young children living with HIV early are being missed — more than one third of children born to mothers living with HIV were not tested.

If untreated, around 50% of children living with HIV die before they reach their second birthday.

Start Free, Stay Free, AIDS Free is a five-year framework that began in 2015.The approach focuses on 23 countries, 21 of which were in Africa, that accounted for 83% of the global number of pregnant women living with HIV, 80% of children living with HIV and 78% of young women aged 15–24 years old who are newly infected with HIV.

Although the 2020 targets were missed, the 21 focus countries in Africa made better progress than the non-focus countries. However, there were major disparities between countries, and these countries still bear the highest burden of disease: 11 countries account for nearly 70% of the “missing children”— those living with HIV but not on treatment. There was a 24% decline in new HIV infections among children from 2015 to 2020 in focus countries versus a 20% decline globally. Focus countries also achieved 89% treatment coverage for pregnant women living with HIV, compared to 85% globally, but still short of the target of 95%, and there were huge differences between countries.

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