A Study in Contrasts: Pediatric HIV in the United States and Abroad

An EGPAF-supported clinic in Rwanda. EGPAF is working in countries across sub-Saharan Africa to eliminate pediatric HIV.

James Pursey/EGPAF

A new study published in the Journal of the Pediatric Infectious Diseases Society found that in the United States, there is an increasing number of HIV-positive children surviving through adolescence and into adulthood, thanks to antiretroviral therapy (ART). Allison L. Agwu, MD, from the Johns Hopkins University in Baltimore, and her research team retrospectively studied 521 HIV-infected youth,  ages 12 and older. The researchers found that from 2002 through 2010, the median age of HIV-infected youth in treatment increased from 14 to 18 years. The proportion of patients prescribed ART increased from 67 percent to 84 percent. These findings indicate that thanks to improved access to ART and long-term treatment programs, HIV-positive children living in the United States are living longer, healthier lives.

This study comes in stark contrast to the pediatric HIV epidemic still facing developing countries, particularly in sub-Saharan Africa.  As a new editorial published in the Public Library of Science (PLOS) Medicine points out, 3.4 million children are currently living with HIV and more than 90 percent of new pediatric infections are the result of mother-to-child transmission of the virus, which can occur in utero, at birth, or through breastfeeding.

While preventing mother-to-child transmission (PMTCT) programs are key to eliminating pediatric HIV, children currently living with the virus must also be a priority on the global HIV/AIDS agenda. HIV-positive children are more vulnerable to the virus than infected adults, and have higher morbidity and mortality rates. Without treatment, one-half of those children infected will die before their second birthday and 80 percent will die before the age of five, yet only one-third of those eligible for treatment are currently receiving medication.

Earlier this year, the World Health Organization (WHO) launched new HIV/AIDS treatment guidelines  calling for expanded pediatric treatment, including immediate initiation of ART for all HIV-positive children younger than five years of age. At the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), we are working with countries worldwide to provide the technical assistance and training to implement these new guidelines and ensure more HIV-positive children have access to ART. As the global HIV/AIDS community continues making progress towards the elimination of pediatric HIV, we hope that the recent progress the community has made to treat pediatric HIV in United States will soon reach HIV-positive children all over the world.

Johanna Harvey is Senior Communications Officer for the Foundation, based in Washington, D.C.