Kulohoma Benard W, Wesonga Colette S A
IAVI Africa, Nairobi, Kenya.
Ortholog, Nairobi, Kenya.
Front Public Health. 2025 Apr 29;13:1565242. doi: 10.3389/fpubh.2025.1565242. eCollection 2025.
Despite a significant reduction in the global HIV disease prevalence in recent years, children under 15 years of age still account for 3% of people living with HIV, 9% of new incidence, and 12% of AIDS-related deaths. Although there is increased access and use of antiretroviral drugs, children under 1 year in resource-poor settings with a high HIV disease burden remain vulnerable due to poor initiation of these critical interventions impeding progress to meet the 95-95-95 targets. There are renewed efforts to ensure that exposed children under 15 years are not left behind by scaling diagnostics and clinical management in the most affected communities. However, gaps remain in the integration of these services into maternal, child, and adolescent healthcare services within these communities, resulting in only 67% of HIV-exposed infants being tested within 2 months of birth, globally in 2023. Consequently, only 29% of all exposed children under 15 years were initiated in antiretroviral treatment before their 5th birthday in 2023. There are successes for adults aged 15 years and above, but children under 15 years risk being left behind in achieving the 95-95-95 targets. In this study, we review efforts made to reduce these substantial regional variations when comparing progress made between children under 15 years and adults and highlight gaps that might impede achievement of the 95-95-95 targets among children.
尽管近年来全球艾滋病毒疾病流行率显著下降,但15岁以下儿童仍占艾滋病毒感染者的3%,新发病例的9%,以及与艾滋病相关死亡人数的12%。尽管抗逆转录病毒药物的可及性和使用率有所提高,但在艾滋病毒疾病负担较高的资源匮乏地区,1岁以下儿童仍然脆弱,因为这些关键干预措施启动不佳,阻碍了实现95-95-95目标的进程。目前正在重新努力,通过在受影响最严重的社区扩大诊断和临床管理,确保15岁以下受感染儿童不被落下。然而,在将这些服务纳入这些社区的孕产妇、儿童和青少年医疗服务方面仍存在差距,导致2023年全球只有67%的艾滋病毒暴露婴儿在出生后2个月内接受检测。因此,2023年所有15岁以下受感染儿童中只有29%在5岁生日前开始接受抗逆转录病毒治疗。15岁及以上成年人取得了成功,但15岁以下儿童在实现95-95-95目标方面有被落下的风险。在本研究中,我们回顾了在比较15岁以下儿童和成年人取得的进展时为减少这些巨大的地区差异所做的努力,并强调了可能阻碍儿童实现95-95-95目标的差距。