Africa is far from on track to reduce new HIV infections among children and young people and is unlikely to significantly reduce new infections among young people before 2030 due to a predicted doubling adolescent population, according to the results of a UNICEF modeling exercise presented at the 22nd International AIDS Conference (AIDS 2018) in Amsterdam on Thursday.
The study looked at what will happen as the population of children and adolescents increases in sub-Saharan Africa over the coming decades. As populations age in other parts of the world, especially in Europe and Asia, Africa will experience a ‘youth explosion’.
The population of adolescents and young people aged 15 to 24 living in sub-Saharan Africa will almost double by 2050, while it will decline or remain stable in all other regions of the world. The incidence of HIV among young women remains high, and the incidence is estimated to have declined by only 3% per year among young people since 2010. As the youth population increases, the total number of young people increases. living with HIV will also increase unless there is a larger and more sustained reduction in the incidence of HIV among young people.
To examine the impact of this demographic transition on HIV among young people, UNICEF used data from UNAIDS HIV estimates, United Nations population projections and other validated sources to develop projections. HIV incidence and prevalence up to 2050 for 141 countries, including 46 countries in sub-Saharan Africa. Africa.
The findings were presented by Aleya Khalifa of UNICEF.
The model compared the results of two trends: the current trend in HIV incidence and antiretroviral coverage, and what might happen if the Fast Track goals to reduce HIV incidence and treatment coverage by 2020 (81% coverage) and 2030 (90% coverage) are achieved. The model also compared trends in treatment coverage for prevention of vertical transmission (mother-to-child), based on the current trend or the achievement of Fast Track goals by 2020 (75 % coverage) and 2030 (95% coverage).
The study found that if current trends prevail, although the number of new infections in children under five will halve by 2030, to around 140,000 per year, new infections in adolescents (aged age 15 to 19) will not be halved until 2050 and will still operate at a rate of around 200,000 per year in 2030.
But the study also found that countries are far from meeting the 2020 targets, let alone the 2030 targets, implying that the ‘current trend’ scenario is very likely to unfold unless efforts are made. important to reach adolescents and prevent new infections in children.
Based on current trends, new infections in children will only decrease by 42% by 2020, instead of the 95% target set by international agreements.
The model reveals that 1.9 million children and adolescents will be living with HIV by 2030, dropping to 1 million by 2050.
Likewise, new infections in adolescent girls aged 15-19 will only decrease by 28%, while infections in boys will only drop by 25%, well below the 75% reduction envisioned under the plans. Three Frees for an AIDS-free generation.
Aleya Khalifa said the projections “should really serve as a warning”.
The study also found that the impact of meeting Fast Track goals for treatment coverage would be more pronounced for new infections in adolescents. While the current trend is for new teenage infections to drop 42% by 2030, new infections would drop 83% by 2030 if 90% treatment coverage could be achieved. A similar reduction in new infections could be achieved in adolescent boys.
Although the study found that, overall, new HIV infections will decline by 70% in East and Southern Africa by 2050, no country in sub-Saharan Africa can expect to reduce new HIV infections. 95% among adolescents and young people by 2030. Current trends and levels of prevention activities, UNICEF estimates that nearly 10 million adolescents and young people will be infected with HIV between 2017 and 2050. Two-thirds of these infections will occur in young women.
The study estimates that only Botswana, Mozambique, Swaziland, Uganda and Zimbabwe will be able to achieve a 95% reduction in new infections among adolescents and young people by 2050. The news share infections occurring in West and Central Africa will increase, in part because of a particularly rapid increase in the infant population in the region, but also because of the slow progress towards the 2020 targets.