A new report released by the United Nations Children's Fund (UNICEF) indicates that nearly 2.1 million adolescents worldwide were living with human immunodeficiency virus (HIV) at the end of last year. Surprisingly, girls accounted for approximately two-thirds of all new HIV infections between the ages of 15 and 19. The report, which was released today, stated three key adolescent populations are most likely to be infected with HIV: sexually exploited adolescents, adolescents who inject drugs, and males who have sex with males (MSMs).

“Strategies to promote gender equality are essential to the fight against HIV in adolescents,” wrote the authors. HIV transmission is also related in some cases, to violence against girls and women. Among adolescents 10 through 19 years old, AIDS-related deaths increased a full 50 percent, a rise from 71,000 fatalities in 2005 to 110,000 in 2012.

“If high-impact interventions are scaled up using an integrated approach, we can halve the number of new infections among adolescents by 2020,” UNICEF Executive Director Anthony Lake stated in a press release. “It’s a matter of reaching the most vulnerable adolescents with effective programs — urgently.” Such interventions would include condoms, antiretroviral treatment, prevention of mother-to-child transmission, voluntary medical male circumcision, communications for behavior change, and targeted approaches for marginalized and at-risk populations. These steps need be taken, the authors indicate, while also continuing investment in education, social protection and welfare, and strengthening health systems.

Option B+

On a positive note, great progress has been achieved in preventing mother-to-child transmission of HIV; 260,000 children were newly infected with HIV in 2012, compared to 540,000 in 2005. Public health authorities believe more than 850,000 new childhood infections were averted between 2005 and 2012 in low- and middle-income countries.

“These days, even if a pregnant woman is living with HIV, it doesn’t mean her baby must have the same fate, and it doesn’t mean she can’t lead a healthy life,” Lake stated. In particular, the authors credit a new, simplified life-long antiretroviral treatment (a daily one-pill regimen known as Option B+) that helps to treat women living with HIV while also preventing the transmission of the virus to babies during pregnancy, delivery, and throughout breastfeeding. Because of this new treatment, high HIV burden countries in sub-Saharan Africa reported remarkable results: New infections among infants declined by 76 percent in Ghana, 58 percent in Namibia, 55 percent in Zimbabwe, 52 percent in Malawi and Botswana, and 50 percent in Zambia and Ethiopia between the years 2009 and 2012.

Despite greater knowledge, prevention, and better treatments, HIV infected children face special challenges unknown to adults. “As children living with HIV grow older, their treatment, care and support needs also change, and they face new challenges in adhering to medications, taking greater responsibility for their own health and accessing the services and information they need to lead healthy and productive lives,” the authors wrote in their report which gained support from the World Health Organization and World Bank, among other entities. Sadly, changing needs and drug adherence are the least of an adolescent's problems. Only 34 percent of children living with HIV in low- and middle-income countries received the treatment they needed in 2012, compared to 64 percent of adults.