The Missed HIV-Positive Children of Ethiopia

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.

Why Are Orphaned Adolescents More Likely to Be HIV Positive? Distinguishing Between Maternal and Sexual HIV Transmission Using 17 Nationally Representative Data Sets in Africa

“…However, recent research has found that HIV infection progresses slowly among some infants and a substantial proportion of HIV positive survive to adolescence and beyond. 13,14 Moreover, recent research in Kenya 15 and Ethiopia 16 has found substantial HIV prevalence for older children (under age 15), the majority of whom were presumably not infected through sexual transmission due to low rates of sexual activity for these age groups. In addition, an intervention to reduce HIV among Zimbabwean adolescents had no impact on orphan HIV disparities, leading the authors to suggest that excess risk among orphans is likely due to maternal transmission.…”

“…Due to the predominant focus on sexual transmission, HIV testing efforts are typically not directed towards this population. 16 As a result, many of these HIV positive children are undiagnosed and not linked to treatment. 15,16 As these “missing children” mature into adolescents, they may alter the future course of the HIV epidemic.…”

“…16 As a result, many of these HIV positive children are undiagnosed and not linked to treatment. 15,16 As these “missing children” mature into adolescents, they may alter the future course of the HIV epidemic. The goal of this study is to clarify the etiology of orphan HIV disparities, and in doing so provide essential guidance for our response.…”

The impact of para-professional social workers and community health care workers in Côte d'Ivoire: Contributions to the protection and social support of vulnerable children in a resource poor country

“…This finding is not only consistent with prior research but adds to argument for consistently using PSWCHW in programming service delivery for vulnerable children. This finding helps support communitybased health care research that has shown PSWCHW help to address a wide range of issues for the vulnerable population, from psychosocial support to adherence to HIV treatment for the population they serve (Pegurri et al, 2015;Taylor & Kvalsvig, 2008) PSWCHW were able to address issues of adherence to health care and to provide supportive mental health interventions, sexual health education, and ways to navigate cultural social spheres to ensure community needs were served (Beard, 2005;Friedman, 2005;Hermann et al, 2009;Pegurri et al, 2015). Their community knowledge helped them use individuals' and family strength to assist them (Heath et al, 2008).…”

“…They have helped to address a wide range of issues, including psychosocial support, adherence to HIV treatment, and nutrition education to support early childhood development (Taylor & Kvalsvig, 2008). Clinical adherence, mental health, sexual health and social spheres must be included in the provision of care for children living with HIV (Pegurri et al, 2015). Social work and public health care intersect when supporting households at the community level (Beard, 2005;Friedman, 2005;Hermann et al, 2009).…”