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As part of their basic human rights, children need access to the best health care possible, safe water to drink, nutritious food, and a clean and safe environment to grow and develop to their full potential. Optimal health, learning and behavior outcomes stem from laying healthy foundations early in life through exposure to the right health care, nutrition, relationships and environment. Whether because of exposure, infection and/or drug effects, HIV impacts health, nutritional, learning and development outcomes. HIV programs need to design and foster approaches that address the multidimensional needs of children living with and/or affected by HIV, recognizing that both exposure and infection carry risks that may affect survival, growth and development for children of different ages.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more. 

Approximately half of HIV infections among children take place during breastfeeding. While there has been success in retaining pregnant women on antiretroviral therapy (ART) during pregnancy, there has been inadequate focus on retention support to
mother-baby pairs (MBPs) during the breastfeeding period.

Literature shows that the majority of MBPs not retained in prevention of mother-to-child transmission (PMTCT) programs are due to loss to follow-up (LTFU) rather than death. These children are at higher risk of vertical acquisition of HIV compared to breastfeeding infants who remain in care. Current postpartum LTFU rates limit successful implementation of PMTCT programs in sub-Saharan Africa. Cumulative sub-Saharan Africa PMTCT LTFU rates in 2011 were estimated to range from 20-28% during antenatal care, then sharply increase to 70% at four months postpartum and reach approximately 81% six months after birth.

Given these staggering statistics, the quality and effectiveness of PMTCT services should include an assessment of the proportion of MBPs retained in care and early infant diagnosis (EID) rates.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.

Motherhood is common among female sex workers (FSWs) and many have at least one biological child. People who inject drugs (PWID), men who have sex with men (MSM) and transgender people (TG) are also part of families and have at-risk spouses and children in their households. Stigma and discrimination towards key populations (KP) can negatively impact their children’s access to health, education and protection services. Program data from Cameroon, Ethiopia and Tanzania reflect positivity rates of 4-6 per cent when children of FSWs are tested for HIV.  Access to early infant diagnosis (EID), HIV testing and treatment and other critical health, social and economic strengthening interventions for children of KP and their families must be improved as a priority.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more. 

Social Protection and HIV: Research Implications for Policy by UNICEF, the Eastern and Southern Africa Regional Inter-Agency Task Team on Children Affected by AIDS (RIATT-ESA) and the Coalition for Children Affected by AIDS contain the following six briefs:

1: How can Social Protection reduce adolescent HIV-risk?

2: Combination Social Protection improves adolescent ART-adherence

3: Combination Social Protection reduces HIV-risk in adolescents

4: Social Protection: potential for improving HIV outcomes among adolescents

5: Social Protection and the Sustainable Development Goals

6: Combination Social Protection lowers unprotected sex in HIV-positive adolescents

The Kingdom of Eswatini (formerly Swaziland) released its National Strategic Plan for Ending AIDS and Syphilis in Children (2018 – 2022). This strategy aligns with the ‘Three Frees’ Framework and aims to make a final push towards the elimination of mother-to-child transmission of HIV and syphilis as well as an end to paediatric AIDS.

This Plan has been designed to ensure that every child is born and remains HIV and syphillis free, and that every pregnant woman or mother living with HIV have access to lifelong HIV treatment. In addition, every child and adolescent living with HIV should be linked to quality HIV treatment, care and support to realize their full potential without stigma and discrimination.

La Coordination Intersectorielle de Lutte contre les IST/VIH/SIDA remercie chaleureusement l’ensemble des acteurs et structures qui ont participé à l’élaboration du Cadre Stratégique National 2008-2012 pour la disponibilité totale et l’implication sans réserve dont ils ont fait preuve.