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Estimation of the Potential Impact of COVID-19 Responses on the HIV Epidemic: Analysis using the Goals Model

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The high possible cost of COVID-19 on new HIV infections among children

New modelling has shown that the COVID-19 pandemic could have a major impact on new HIV infections among children in sub-Saharan Africa.

Since 2010, new HIV infections among children in sub-Saharan Africa have declined by 43%, from 250 000 in 2010 to 140 000 in 2018, owing to the high coverage of HIV services for mothers and their children in the region. However, if those services were disrupted because of the COVID-19 response, those gains would be reversed, with a six-month curtailment seeing new child HIV infections rising drastically, by as much as 83% in Mozambique, 106% in Zimbabwe, 139% in Uganda and 162% in Malawi.

There were approximately 30 000 new HIV infections among children (aged 0–14 years) per year in Uganda in the 1990s and early 2000s. The provision of antiretroviral medicines to prevent mother-to-child transmission scaled up from just 9% of expectant mothers living with HIV in 2004 to more than 95% by 2014, and that high coverage has been maintained since. New HIV infections among children (aged 0–14 years) plummeted to an estimated 11 000 in 2014; they further declined to 7500 in 2018. But the impact caused by COVID-19 could be high.