Large number of children living with undetected HIV, experts warn

Saturday February 12 2022
Medical centre

A medical centre for HIV patients in Lomé, Togo. Globally, 1·7 million children younger than 15 years are estimated to be living with HIV. PHOTO | AFP


Close to 40 percent of children aged one to 14 years across seven African countries are estimated to be living with undiagnosed HIV.

Health experts say 166,000 children living with HIV in Tanzania, Zambia, Eswatini, Lesotho, Malawi, Namibia and Zimbabwe are not on antiretroviral therapy (ART) and this is indicative of the prevalence of missed HIV diagnosis among children in sub-Saharan Africa.

The study, published February 1 in The Lancet HIV, reveals that among children living with HIV in the seven countries, only 55 percent were on ART and of these only 32·6 percent had a suppressed viral load. The global target coverage is 95percent. This shows that a large population of children remain at risk of Aids and death despite widely available antiretroviral treatment.

“In part, the high number of undiagnosed cases in children reveals the persistent challenges in early infant diagnosis in high HIV endemic countries, especially in sub-Saharan Africa, that keep many children living with HIV out of care. In sub-Saharan Africa, ART coverage for children still lags behind that of adults,” says the report.

The scientists are now calling for urgent strengthening of early infant diagnosis.

“An increase in testing, ART initiation and retention in care for children living with HIV are essential to make an Aids-free generation a reality,” they said.


Overall, less than half of the children in sub-Sahara Africa get diagnosed early for HIV.

In Tanzania 50 percent of the estimated 101, 000 total children living with HIV are undiagnosed.

Testing infants

Globally, 1·7 million children younger than 15 years are estimated to be living with HIV, and only 54 percent were on antiretroviral therapy in 2020.

“Over the past two decades, important progress has been made in implementing services to prevent mother-to-child (vertical) transmission of HIV and to access and uptake of HIV testing for infants and children in countries with a high HIV burden.

“During the period of upscaling, however, many children living with HIV did not receive HIV testing, and gaps remain in efforts to test all HIV-exposed infants and children,” said the health experts.

The scientists advise that HIV testing for children be integrated in routine maternal, child and community health programmes to reduce missed opportunities in diagnosis.

The study was done by ICAP (previously International Centre for Aids Care and Treatment Programmes)’s Population-based HIV Impact Assessment teams and the CUNY Graduate School of Public Health & Health Policy in the US.

“While we know that we are falling short of providing treatment for all children living with HIV, an unknown aspect of the paediatric treatment gap has been an understanding of how many children are not on ART because they have never been diagnosed,” noted assistant professor of epidemiology and biostatistics at CUNY ISPH, Chloe Teasdale.

The healthcare experts concluded too that the undiagnosed cases aggravated the inequality in acquisition of care for children in the Global South.