Eastern and Southern Africa

Despite global progress in HIV treatment for children, the gap between adult and paediatric treatment coverage continues to widen. This gap is driven primarily by barriers to HIV diagnosis in children, but in the past decade those barriers have shifted.

Scaling-up HIV case-finding efforts for children presents several challenges, including limited access to testing services, lack of provider preparedness to offer testing to children, stigma and discrimination, policy barriers related to age of consent, and inadequate health systems. The aim of this technical brief is to offer countries a guide to address these challenges and enhance HIV case-finding for children to improve testing coverage for children at risk for HIV. This technical brief focuses primarily on how programmes can identify those children who may have missed out on EID testing, who were never tested after breastfeeding or whose mothers were not enrolled in care.

The 22nd International Conference on AIDS and STIs in Africa (ICASA) is taking place in Harare, Zimbabwe on 4-9 December, 2023. Download UNICEF's Roadmap below to find conference sessions related to children, adolescents and pregnant women.

Please also refer to the roadmap from Y+ Global for an overview of all youth-focused or youth-led sessions and save-the-dates for satellite sessions convened by UNICEF and partners.

This synthesis report reflects a comprehensive review of the body of research undertaken through the Evidence-to-Action partnership.

With support from the Joint UN 2gether 4SRHR programme, a research partnership with the University of Oxford and University of Cape Town was established with the aim to improve HIV, SRH, and the overall well-being of adolescents by providing sustainable and scalable services. The partnership, which was ongoing from 2018 to 2023, investigated drivers of HIV and SRH risk in adolescents, and was committed to generating and using the latest evidence to propose practical solutions, shape programmes and guide decision-making for adolescents.

The results of the partnership are being used in integrating evidence into programming for adolescents throughout the region. They are summarized in a synthesis report, along with the six evidence-to-action briefs featured here.

UNICEF's annual global and regional epidemiological and response snapshots of Eastern and Southern Africa, West and Central Africa, and the Middle East and North Africa, based on the UNAIDS 2023 HIV estimates.

The snapshots describe where we are in terms of vertical transmission, the treatment gap, and the impact on adolescents.

In 2022 an estimated 930,000 children (aged 0-14 years) were living with HIV in Eastern and Southern Africa. Nearly one-third of these children were not receiving lifesaving treatment. Children with HIV need both antiretroviral treatment and viral load suppression if they are to lead long and healthy lives.

UNICEF, in collaboration with governments and partners, supported an updated analysis of laboratory information management systems (LIMS) data in Malawi, Uganda and Zimbabwe from 2017-2020 to better understand viral suppression among children, especially in the context of WHO recommendations for newer, more efficacious drug regimens and the COVID-19 pandemic.

A previous analysis of 2016-2018 LIMS data found that one in every three children was not virally suppressed. The updated study found a steady increase since then in viral load testing, the use of more efficacious and palatable antiretroviral regimen options, and improved viral load suppression. However, children are still falling short of global targets to end AIDS by 2030. The full report describes the methodology, key findings, limitations, and proposes further prioritization and accelerated action to improve treatment outcomes for children with HIV.