Paediatric and Adolescent Treatment

This second edition of AA-HA! guidance to support country implementation builds on the first edition published in 2017. It is a collaborative effort spearheaded by the World Health Organization in collaboration with UNAIDS, UNESCO, UNFPA, UNICEF, UN WOMEN, the World Food Programme and PMNCH.

Building on the solid foundation of the first edition and voices of adolescents and young adults around the world, this multi-agency product has evolved to incorporate valuable learnings from the past six years, including of the COVID-19 pandemic's impacts. Latest estimates of mortality and disease burden, updated evidence, and a broader focus on wellbeing make the second edition a cutting-edge resource for policy makers in the area of adolescent health and well-being.

AA-HA! 2.0 offers insights into the current health and well-being landscape of the world’s over 1.2 billion adolescents, underlining evidence-based solutions and presenting strategies for priority setting, planning, implementing, and evaluating health and well-being programmes. The inclusion of key implementation strategies and real-world case studies make this guide a practical tool for governments in designing and implementing a new generation of adolescent health and well-being programmes.

Dolutegravir (DTG)-based HIV treatment regimens are recommended by the World Health Organization for children living with HIV (CLHIV) who weigh at least 3 kg. In 2020, the United States Food and Drug Administration (US FDA) granted tentative approval of paediatric DTG 10 mg scored, dispersible tablets (pDTG) for CLHIV weighing a minimum of 3 kg and at least four weeks of age. In early 2021, national HIV programmes in low- and middle-income countries (LMICs) began to transition CLHIV from treatment regimens containing non-nucleoside reverse transcriptase inhibitor (NNRTI) and lopinavir/ritonavir to pDTG. As of the last quarter of 2022, at least 73 countries have already placed or received orders for pDTG1 and an estimated 130,000 children have transitioned to pDTG. pDTG currently is administered along with optimised backbone antiretrovirals (ARVs) such as abacavir/lamivudine 120/60 mg scored dispersible tablets (pABC/3TC) per the WHO’s 2021 Consolidated HIV Guidelines.

This brief aims to inform the transition from pDTG + pABC/3TC to the new fixed-dose combination (FDC) dispersible tablet of paediatric ABC/3TC/DTG 60/30/5 mg (pALD).

This brief, the first in UNICEF's new Leveraging the Learning series, sets out to leverage the learnings from holistic, integrated, multisectoral, and age- and gender-responsive approaches to respond to and reduce early and adolescent pregnancy, support young mothers, and improve health and well-being outcomes for adolescent girls and their children. 

Highlighting promising practices for pregnant adolescents living with HIV, the report is relevant for efforts to support all pregnant adolescent girls, regardless of their HIV status.

In this viewpoint Getting back on track to ending AIDS in Children: It could just be easier than you think, published in the Journal of the International AIDS Society on World Children's Day, 20 November 2023, UNICEF reviews the global inequities faced by children and adolescents living with HIV and highlights three strategies to end AIDS in children by 2030.

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.

On this International Day Against Homophobia, Biphobia and Transphobia (IDAHOBIT) 2023, we unveil the UNICEF Spotlight Report on the Youth Aware initiative in Brazil. Youth Aware is a partnership with the Brazilian Ministry of Health, to transform the approach to HIV and STI prevention and treatment for LGBTQI+ youth through peer education and community mobilization. Young people in Brazil are disproportionately impacted by the HIV epidemic, and key populations face heightened vulnerability.

Supported by M·A·C VIVA GLAM, this flagship UNICEF programme redefines health services for adolescents, addressing their needs and the shifting landscape of gender and sexuality. The report showcases the stories of courageous individuals countering prejudice and sheds light on their aspirations and challenges. Together, we can challenge stigma, discrimination, and marginalization, advocating for a future where every young person can thrive. Join us as we celebrate IDAHOBIT and champion a healthier, more inclusive future.

The Republic of Uganda Ministry of Health has released its National Pediatric and Adolescent HIV Advocacy Strategy And Road Map 2022-2026, disseminated in Kampala during October 2022. 

The overall objective of this strategy is to complement and catalyze the ongoing national programs targeted at improving pediatric and adolescents HIV outcomes by addressing the policy and resource allocation gaps. This will be through putting in place a uniform and harmonized technical approach to advocacy across the national response stakeholders. The strategy provides standardized practical approaches to guide stakeholders in planning, designing, implementing and evaluating advocacy initiatives in support of pediatric and adolescents HIV. The strategy will institute systems to keep truck of ongoing and new advocacy initiatives to ensure they are aligned to the advocacy issues highlighted in the strategy for continuous process quality improvement and mitigate risks associated with uncoordinated advocacy initiatives. 

This document provides a compilation of tools, best practices and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. It emphasizes the importance of integrating HIV prevention, testing, treatment and care; mental health services and care for people living with HIV.