New HIV infections among adolescents projected to rise by nearly 60 per cent by 2030 if progress stalls – UNICEF

Urgent action needed to improve HIV prevention and treatment for young people 

NEW YORK/JOHANNESBURG/ADDIS ABABA 1 December 2016 – New HIV infections among adolescents are projected to rise from 250,000 in 2015 to nearly 400,000 annually by 2030 if progress in reaching adolescents stalls, according to a new report released by UNICEF today. 

“The world has made tremendous progress in the global effort to end AIDS, but the fight is far from over – especially for children and adolescents,” said UNICEF Executive Director Anthony Lake.  “Every two minutes, another adolescent – most likely a girl – will be infected with HIV. If we want to end AIDS, we need to recapture the urgency this issue deserves — and redouble our efforts to reach every child and every adolescent.” 

AIDS remains a leading cause of death among adolescents, claiming the lives of 41,000 adolescents aged 10-19 in 2015, according to the 7th Stocktaking Report on Children and AIDS: For Every Child: End AIDS.

The report proposes strategies for accelerating progress in preventing HIV among adolescents and treating those who are already infected. These include:

·         Investing in innovation including in locally grown solutions.

·         Strengthening data collection.

·         Ending gender discrimination including gender-based violence and countering stigma.

·         Prioritising efforts to address adolescents’ vulnerabilities by providing combination prevention efforts including pre-exposure prophylaxis, cash transfers and comprehensive sexuality education.

Globally there were nearly 2 million adolescents aged 10 -19 living with HIV in 2015. In sub-Saharan Africa, the region most impacted by HIV, girls accounted for three out of every four new infections among adolescents aged 15-19.

Other findings in the report include:

·         Remarkable progress has been made in preventing mother-to-child transmission of HIV. Globally, 1.6 million new infections among children were averted between 2000 and 2015.

·         1.1 million children, adolescents and women were newly infected in 2015.

·         Children aged 0–4 living with HIV face the highest risk of AIDS-related deaths, compared with all other age groups, and they are often diagnosed and treated too late. Only half of the babies born to HIV-positive mothers receive an HIV test in their first two months, and the average age that treatment begins among children with vertically acquired HIV in sub-Saharan Africa is nearly 4 years old.

Despite progress in averting new infections and reducing deaths, funding for the AIDS response has declined since 2014, UNICEF said. 

Haregua Askale stands in her traditional bar waiting for customers

In Ethiopia, the prevalence of HIV is low compared to other African countries. In 2011, 1.5 per cent of the population between the ages of 15 and 49 was HIV positive. However, taking into account the country’s large and growing population, the absolute number of people infected with HIV is high. By the end of 2015, the estimated number of people living with HIV was 740,000 including 84,000 children under the age of 15 years.

The 2011 Ethiopian Demographic Health Survey (EDHS) has provided evidence that the epidemic continues to be highly heterogeneous by region, ranging from the lowest (0.9 per cent) in SNNPR to the highest (6.5 per cent) in Gambella. The survey also indicates disparity by gender (1.9 per cent) for adult women whereas (1.0 per cent) for adult men. HIV prevalence is also increasingly concentrated in large urban areas and along major transport corridors. According to the 2015 Ethiopia Public Health Institute (EPHI) study, 67 per cent of people living with HIV reside in urban areas. 

Young people are often at a greater risk of infection. They may have shorter relationships and more partners, or engage in risky sexual practices. Also, girls are at a high risk of HIV infection due to gender-based inequality and partner violence.

Over the last ten years, Ethiopia has dramatically reduced new infections and AIDS related deaths by more than 50 per cent (UNAIDS 2015). As part of the global target to end AIDS by 2030, UNAIDS sets new targets for 2020 referred to as 90:90:90 – which implies reaching- 90 per cent of HIV testing, 90 per cent of Antiretroviral Treatment and 90 per cent of reducing viral load. By the end of 2015, Ethiopia had already enabled more than 60 per cent of the people living with HIV to know their status and 52 per cent, or more than 386,000 of people living with HIV to receive Antiretroviral Treatment (Global AIDS Response Progress Reporting ETHIOPIA: 2015 REPORT).

The effort to eliminate mother-to-child transmission is also on track, whereby, 67 per cent of HIV-positive pregnant women access and receive Antiretroviral Treatment to reduce the risk of mother-to-child transmission during pregnancy and delivery (EPHI-2015).

Since 2014, ART clients in Ethiopia have been getting their CD4 status in 20 minutes

By Tesfaye Simerta

Ayele Feyisa Laboratory technical take sample of blood
Ayele Feyisa Laboratory technician takes sample blood at Chancho health centre, Oromia special zone surrounding Finfinne Sululta woreda, Ethiopia ©UNICEF Ethiopia/2014/Ayene

CHANCHO TOWN, OROMIA REGION, ETHIOPIA, 23 October 2014 – The Chancho Health Centre, 45kms north of Addis Ababa, is where Rediet* goes for her follow-ups, having discovered she was HIV positive back in 2013. Today, there are lots of people waiting alongside Rediet to utilise the laboratory services. Chancho is one of the health centres that the Ethiopian Government – supported by the Clinton Health Access Initiative (CHAI), UNITAID and UNICEF – is using to advance access to Point of Care Technologies (POCT). These provide results on the same day, in order to make HIV testing and treatment more effective, efficient and easier for both health care workers and patients.

Now, Rediet is a mother of a one-year-old baby girl and is still following up on her status regularly.

“Now I have stopped having to wait to hear my CD4 count status at the Fiche Hospital, far from here,” said Rediet, who used to have to travel to Fiche Town to get the test done. “When I went to Fiche, I was paying transport expenses for a round trip, but here it is accessible – about an hour and half walking distance from my home. Previously, when my blood sample was sent to Fiche Hospital, I was not able to know my CD4 count status for a month or more and could not receive treatment. Now that the machine has arrived in the Health Centre, I get my results just after 20 minutes of testing, receive my treatment here and then go home.”

According to Mr Asfaw Referra, Anti-Retroviral Treatment (ART) Focal Person at the Chancho Health Centre, there are now around 500 clients using the CD4 count of POCT, of which one in ten are children. “Clients are very happy about this machine, since they can discover their CD4 count status just after 20 minutes,” he told us. “There were clients whose CD4 counts had dropped as low as 93. As they start their ART treatment immediately after we know their CD4 count, however, we are very excited when these people show signs of improvement.”

In addition, before the POCT machine was introduced to the Chancho Health Centre, the number of clients allowed to give blood samples was restricted.

Aduna Lema is one of the many client in Chancho health center“The sample we used to take to Fiche hospital was restricted to between 10 and 15,” Abebe Gelme, Chancho Health Centre Laboratory Technician, informs us. As a result, Chancho Health Centre was forced to transport the samples every week. “Despite the large demand, we appointed only 10 to 15 clients to give their blood sample to our Health Centre up until 9 am every Friday morning, since the collected blood samples had to be taken to Fiche right away.”

Some clients coming from far away could not reach to the Health Centre before 9am and missed their chance. They were then appointed to come back again the following week. Often, they did not get the opportunity to have their blood samples taken and felt helpless.

“I know a client whose CD4 count was found to be eight,” Abebe told us. “Now, thanks to the POCT machine, I can have the data and tell the exact status of my client’s CD4 count with confidence.”

The POCT services are now becoming popular, both at the government level and at the grassroots level.

“The Oromia Regional Health Bureau is committed to working with partners,” Asfaw Endebu, Woreda Health Office Head, told us with great pride. “The woreda cabinet knows about the service provided at this Health Centre and we have recently started introducing it to the Health Workers and Health Extension Workers. We are informed about the availability of the machine, and that is why other HCs and HPOs refer cases to this centre.”

With the support of partners, 45 sites with high patient volume, like Chancho Health Centre, have received POCT machines at the initial stage. This ensures that women, like Rediet, and children in remote areas especially will not have to spend time and resources in order to discover their results. This will remove delays and enable more individuals to receive the treatment they need.

*Name changed to protect identity

UNICEF Advocates in Ethiopia and Chad joins hands to support HIV/AIDS prevention interventions

By Wossen Mulatu

Group photo at Addis Ketema Youth Centre with visitors from UNICEF Chad.
Group photo at Addis Ketema Youth Centre with visitors from UNICEF Chad: Mani Virgille Djelassem, 16 years old and UNICEF Chad’s Youth Advocate, Far left and Tommy T. Gobena, UNICEF Ethiopia supporter, centre red shirt. ©UNICEF Ethiopia/2015/Baiguatova

27 January 2015: UNICEF Chad’s Youth Advocate, 16 year old Mani Virgille Djelassem, and UNICEF Ethiopia Supporter- Tommy T. Gobena visited the Addis Ketema Youth Centre and its HIV prevention activities today.

The Chadian National Council for the fight against AIDS, in collaboration with UNICEF Chad, nominated the 16-year-old Mani as a National Youth Advocate to intensify the communications activities around the issue of HIV/ AIDS among youth and adolescents. Her appointment was officially presented by the First Lady of Chad, Mrs Hinda Deby, during the celebration of World AIDS Day on 1st December last year.

Tommy T. Gobena, a bass player in ‘Gogol Bordello’- a renowned international rock band- has been closely working with UNICEF in conveying messages on HIV/AIDS prevention. Tommy’s public service announcement (PSA) entitled “Your life; Your decision” produced by UNICEF in collaboration with the Federal Ministry of Health (FMoH) and UNAIDS has received extensive public viewers and positive feedback on social media after its release on World AIDS Day last year.

Tommy believes that ignorance about the disease is a great enemy. “Education and knowledge should be a big part of the fight against HIV/AIDS. HIV is now a treatable medical condition. Through providing the necessary information, we can reduce HIV prevention as well as the stigma attached to it.”

The duo observed the Addis Ketema Youth Centre’s youth activities, including the library, cafeteria, Voluntary Counseling and Testing and game centres, and met with young beneficiaries. While discussing the issue of HIV/AIDS, Tommy and Mani highly encouraged them to get tested and know their HIV status as early as possible.

”The sooner you know your HIV status, the more options there are available to you.” said Mani.

“You can prevent infection to others if you find out you are HIV positive and you can seek medical care early and live a healthy life. If you test negative, you can continue to protect yourself from the virus by avoiding risky sexual behaviour,” reiterated Tommy.

Tommy and Mani also had the opportunity to meet with the Director of the Disease Prevention and Control Directorate at the Federal Ministry of Health, Dr Mahlet Kifle, and the HIV Team Coordinator, Dr Frehiwot Nigatu.

“I highly encourage adolescents in Ethiopia to be a champion for change and share their knowledge about HIV with each other.” said Mani.

Dr. Mahlet Kifle on her part said, “In order to prevent the prevalence of the HIV virus among adolescents and young people, the appointment of such committed advocates is key. Likewise, we will do all the needful to support and work together with such champions for HIV prevention in Ethiopia by also taking the example of Chad.”

In Ethiopia, the prevalence of HIV in terms of percentage of the population is low compared to other African countries. In 2011, 1.5 per cent of the population between the age 15 and 49 was HIV positive. In 2005, this rate was 1.4 per cent. However, taking into account the large population, the absolute numbers of people infected with HIV is high. Young people are often at a greater risk to become infected with HIV. They may have shorter relationship spans and therefore more sexual partners, or they may engage in risky sexual practices. Girls face a higher risk of HIV infection than boys.

In 2011 DHS report, 0.2 per cent of adolescent girls (aged 15-19) were HIV positive compared to 0 per cent of boys. This rate has declined since 2005, when this rate was 0.7 per cent of girls and 0.1 per cent of boys.[1]