Abstract
ObjectiveAs elsewhere, due to scarcity of data and limited awareness of HIV infection, especially in older children, the HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage is of only 12% in 2013). This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC) households.Design/MethodsWe analyzed national HIV data for Ethiopia, using Spectrum/ Estimation and Projection Package (EPP) and primary data on children living in households with at least one HIV-positive adult in the Amhara and Tigrai regions. Descriptive analysis of the age and sex distribution of HIV-positive OVC in Ethiopia was performed.ResultsOur Spectrum/EPP analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81•6%) were aged five to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11•9% were HIV-positive, the majority of whom were between five and 10 years old with no significant difference between males and females.ConclusionsThere is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services.
Highlights
Improved coverage and effectiveness of prevention of mother-to-child transmission (PMTCT) programs has reduced new HIV infections among children under 15 years old by 40 per cent globally between 2009 and 2013 [1]
There is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized
There were about 3Á2 million children under 15 years of age worldwide living with HIV in 2013, comprising 9Á1% of all people living with HIV, with the vast majority residing in Sub-Saharan Africa [1]
Summary
Improved coverage and effectiveness of prevention of mother-to-child transmission (PMTCT) programs has reduced new HIV infections among children under 15 years old by 40 per cent globally between 2009 and 2013 [1]. There were about 3Á2 million children under 15 years of age worldwide living with HIV in 2013, comprising 9Á1% of all people living with HIV, with the vast majority residing in Sub-Saharan Africa [1]. In 2013, while 38% of adults living with HIV worldwide received antiretroviral therapy, only 24% of children living with HIV obtained HIV treatment [1]. The limited data on survival among slow progressors among vertically infected children has resulted in failure to anticipate the magnitude of the epidemic [4, 5]
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