| dc.description.abstract |
Forty years ago, the first adult HIV cases were published, with
infant cases following within a year [1]. As a few of these
then-babies approach their 40th birthdays, both their growth
and science’s growth tell dramatic stories. Antiretroviral ther apy (ART) transformed HIV from a deadly infection into a
chronic disease. Just as miraculous, an AIDS-free generation
became imaginable, using ART to prevent >95% of perinatal
transmission. While these advances in HIV prevention and
treatment deserve celebration, attention should be devoted to
remaining hurdles – such as behavioural, social viral suppres sion and drug resistance challenges – that must still be over come to ensure successful life-long outcomes for the global
population of children and adolescents who have grown up
with HIV (CAWH).
The global HIV impact for CAWH continues to be enor mous: in 2020, 1.8 million children under 14 live with HIV,
and every day 400 still acquire HIV and 270 die from it.
Although ART access has expanded, only 53% of CAWH
were receiving ART in 2019. Many countries do not screen
mothers or infants for HIV, which leads to perinatal trans mission, late childhood diagnosis, and deaths. Two million
adolescents live with HIV globally, approximately 80% in
sub-Saharan Africa, for whom HIV remains the top cause of
death. Older adolescents (15 to 19 years) are the only age
group in which HIV-related deaths are not decreasing. In
the face of these young deaths, current care models clearly
are not working; of adolescents 10 to 19 years with HIV,
only 43% engage in care, 31% are retained in care and a
dismal 30% are virally suppressed [2]. Added challenges of
COVID-19 pandemic-related disruptions on HIV testing and
care remain to be fully quantified and understood for
CAWH |
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