ART and Treatment

This document highlights opportunities for both public and private sectors to engage in the global HIV response for infants, children, and adolescents in partnership with UNICEF. Below is also a spotlight on the Global HIV and AIDS Thematic Fund, with financial results from 2023 programming.

UNICEF is a key partner and leader in the AIDS response for children, adolescents, and women. It collaborates with governments and partners worldwide, offering innovation, technical expertise, data and evidence, programme excellence, coordination, and convening power.

UNICEF is 100 per cent voluntarily funded, and is seeking support to deliver ambitious HIV results for children and to ensure the world can reach Sustainable Development Goal Target 3.3, to end the epidemic of HIV by 2030. 

UNICEF’s HIV/AIDS Thematic Fund is a global flexible funding pool. It enables us to strengthen systems to ensure an AIDS-free future for children and adolescents. This offers donors an exciting opportunity to target funding specifically to HIV/AIDS outcomes, while also giving UNICEF the flexibility to allocate funds based on where the need is greatest for children, including critically underfunded priorities at the country level, humanitarian response activities, and where funds will have the greatest impact. Thanks to our generous donors UNICEF’s Global HIV/ AIDS Thematic Fund income in 2022 reached over $5.7 million.

This document features the results achieved in 2022, when supporters of the HIV/AIDS Thematic Fund enabled UNICEF to allocate resources to 45 countries and territories. Funds were allocated to countries based on several measures determining the burden of HIV/AIDS on the population. These included the number of AIDS-related deaths in the country and the number of new infections among children and adolescents in the country. Funds were also allocated to UNICEF’s regional and global headquarters, supporting the vital work that allows thematic funding to unlock wide-scale results and impact the world over.

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).

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.

This report presents the results of a study commissioned by UNICEF Tajikistan in collaboration with the Republican AIDS Centre and the NGO Guli Surkh to evaluate the impact of social allowances on the treatment outcomes of children living with HIV in Tajikistan. Of the 7,552 persons living with HIV in Tajikistan today, 10.2 per cent are children under the age of 18. As of December 2017, 90.5 per cent of these children were covered with antiretroviral therapy.

This brief addresses integration of HTS into FP services. It is intended as a practical resource for national health programmes seeking to introduce or scale up HIV testing and linkage to HIV prevention, STI, and antiretroviral therapy (ART) services in FP.

Building on research findings and effective interventions in low-and middle-income countries, this policy brief identifies key risks, including bullying and stigma, and facilitators, such as positive parenting and social support, that influence pathways between mental health and HIV outcomes for adolescents. It is part of a broader series that aims to support the translation of research into improved adolescent sexual reproductive health and HIV programming.

Good mental health and psychosocial wellbeing is especially important for adolescents during their transition to adulthood. It can support resilience and help initiate healthy behaviours that shape long-term positive health outcomes. Evidence shows that adolescents living with HIV are more likely to experience mental health challenges compared to their peers who do not have HIV. Poor mental health outcomes have been linked to low rates of adherence to life-saving antiretroviral treatment (ART) and retention in care.  Understanding risk factors and protective factors that influence mental health and ART adherence amongst adolescents is critical for effective programming. Within eastern and southern Africa, there is great momentum to identify and scale-up interventions that address mental health and improve treatment, care and support for adolescents living with HIV.

Adolescents in Eastern and Southern Africa (ESA) are key to achieving the global goal of ending the AIDS epidemic by 2030. ESA is home to 1.74 million adolescents living with HIV (ALHIV), representing 60 per cent of this population globally. In 12 ESA countries, AIDS is the leading cause of adolescent mortality. While there is an increasing focus on adolescents, the pace of progress remains slow, especially when compared with the growing needs of ALHIV.

It is time to deliver programmes at scale to address the needs of ALHIV, accelerating evidence of interventions producing results or showing significant promise for scale. This document examines and consolidates the current experiences of ALHIV programming in the region to support further implementation and scale-up of evidence-driven models. The findings serve as a call to action and the key considerations as a guide for governments and funding and implementing partners in scaling up service delivery to ALHIV.