Infants

This review of prevention of maternal-to-child transmission (PMTCT) services in the Kyrgyz Republic was undertaken to: (1) provide an overview of milestones in the delivery and expansion of PMTCT for the period 2017-2020; identify the main barriers to PMTCT for women and infants; (3) describe the status of the country’s preparations for validation of elimination of mother-to-child transmission (MTCT) for HIV and syphilis; and (4) provide recommendations to accelerate the country’s progress in strengthening PMTCT services and defining a pathway to application for global validation of elimination of MTCT of HIV and syphilis.

This status report shows how far we have come—and how much further we must go—if we hope to meet the global commitments to end AIDS in children. It offers a snapshot of global progress and permits an early assessment of the impact of the Global Alliance’s work. This report highlights the transformative work that is being undertaken in Global Alliance countries to accelerate gains towards ending AIDS in children, underscoring the urgent need to apply good practices, emerging innovations and critical lessons learned to overcome the barriers that slow progress.

For additional information, consult the joint press release and the video created for the report launch at AIDS 2024.

The purpose of this study is to provide an assessment and analysis of the situation of people living with HIV/AIDS (PLWH) in the Republic of Moldova in the context of the COVID-19 pandemic, including COVID-19 awareness and concern, socioeconomic status, quality of life, mental health and social support, access to medical care/treatment (including digital methods), and stigma and develop recommendations for key government stakeholders to address the identified challenges and mitigate the negative impacts of COVID-19.

 This study considers available statistics and latest trends, including an analysis of the data before and during the pandemic, as well as quantitative and qualitative data collected in the field. The study also highlights the situation of pregnant women and children of caretakers with HIV or with HIV themselves.

Key findings: The COVID-19 pandemic has had widespread implications on the health and well-being of PLWH in the Republic of Moldova. One-fifth of PLWH in the national survey reported being severely affected by the pandemic and one-third reported being moderately affected. The multifaceted dimensions of PLWH’s vulnerabilities, compounded with restrictions during COVID-19 lockdowns, resulted in job loss, limited access to treatment, and continued stigma.

COVID-19 awareness and concern: 

• PLWH received the bulk of COVID-19-related information from online news sources and TV. Less than half of all respondents felt family doctors were a good source of information.
• Over one-third of PLWH said they were “definitely willing” to get the COVID-19 vaccine. A slightly smaller portion, reported no intention of receiving the vaccine at all.Socioeconomic indicators

Socioeconomic indicators: 

• 1 in 10 PLWH experienced job loss.
• Decrease in income was reported by half of all PLWH. Pandemic-induced income reduction was more frequent among urban dwellers.
• More than half of PLWH expressed concerns regarding financial sustainability and ability to pay daily expenses (utilities, food, drugs).
• Half of households spent savings, borrowed money, and bought cheaper food to cope with economic hardships during the COVID-19 pandemic. 2 in 5 limited their personal food consumption.
• More than half of PLWH reported anxieties tied to not being able to pay utilities and buy medication.
• Out-of-pocket expenses related to HIV care were reported by 56% of PLWH.

Quality of life: 

• Self-reported quality of life during the COVID-19 pandemic was very poor to poor among over a quarter of PLWH.
• Self-reported deterioration in health during the COVID-19 pandemic was reported by 17% of PLWH. Deterioration was expressed at a higher rate among the male population.

Access to medical care/treatment: 

• Nearly 1 in 10 respondents had a lack of knowledge regarding existing HIV/AIDS programs offered by healthcare facilities during the COVID-19 pandemic and therefore had not accessed them.
• 1 in 10 PLWH reported cancelled medical visits between July 2020 – July 2021. 
• A quarter of PLWH indicated that the frequency of their visits to healthcare facilities had decreased during the COVID-19 pandemic period when compared to pre-pandemic periods. 
• Fear of contracting COVID-19 was the most cited barrier in accessing healthcare facilities, reported by 41% of PLWH. 

Find the recommendations in the report.

This document highlights opportunities for both public and private sectors to engage in the global HIV response for infants, children, and adolescents in partnership with UNICEF. 

UNICEF is a key partner and leader in the AIDS response for children, adolescents, and women. It collaborates with governments and partners worldwide, offering innovation, technical expertise, data and evidence, programme excellence, coordination, and convening power.

UNICEF is 100 per cent voluntarily funded, and is seeking support to deliver ambitious HIV results for children and to ensure the world can reach Sustainable Development Goal Target 3.3, to end the epidemic of HIV by 2030. 

This is the first report on progress towards the triple elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and hepatitis B virus (HBV) across 23 countries in the Middle East and North Africa/ Eastern Mediterranean (MENA/EM) region.

Countries included in this report: Algeria, Afghanistan, Bahrain, Djibouti, Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, State of Palestine, Saudi Arabia, Somalia, Sudan, the Syrian Arab Republic, Tunisia, United Arab Emirates, Yemen.

To support countries in the region to achieve triple elimination goals, this report collects and assesses national policies and key indicators on EMTCT efforts against WHO criteria for validation of the EMTCT of HIV, syphilis and HBV. Based on analysis and consultations with national policymakers, the report provides a Road Map  for countries at different stages of readiness to follow towards triple elimination goals. The report also provides a set of recommendations for all countries to prioritize EMTCT policy and programming actions over the short, medium, and long term.

Despite global progress in HIV treatment for children, the gap between adult and paediatric treatment coverage continues to widen. This gap is driven primarily by barriers to HIV diagnosis in children, but in the past decade those barriers have shifted.

Scaling-up HIV case-finding efforts for children presents several challenges, including limited access to testing services, lack of provider preparedness to offer testing to children, stigma and discrimination, policy barriers related to age of consent, and inadequate health systems. The aim of this technical brief is to offer countries a guide to address these challenges and enhance HIV case-finding for children to improve testing coverage for children at risk for HIV. This technical brief focuses primarily on how programmes can identify those children who may have missed out on EID testing, who were never tested after breastfeeding or whose mothers were not enrolled in care.

This key considerations document, developed by UNICEF and WHO, expands on the 2020 “last mile” operational guidance, with specific considerations for countries with lower HIV prevalence. It builds on the experiences of countries that have been validated for EMTCT of HIV and syphilis and translates the valuable lessons and promising practices of these countries into an operational framework for national programmes, consisting of 12 strategies and enablers to guide efforts towards Fast-Tracking EMTCT in lower prevalence countries.

It is based on a review of experiences, key lessons learned and promising practices in implementation of EMTCT interventions in lower prevalence countries, including Sri Lanka and Thailand, which have been validated by WHO for having eliminated vertical transmission of HIV, and three countries with the potential to achieve EMTCT by 2030: the Democratic Republic of the Congo, Ghana and India.

This brief reviews existing resources and analyses potential bottlenecks for the processes in applying for EMTCT/Path to Elimination and to strengthen ongoing PMTCT programmes in such applications. Eight UNICEF priority countries were selected for the review: Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Ukraine, and Uzbekistan.

This 2023 framework from WHO and partners guides operationalization of a person-centred and integrated approach to interventions that country programmes can use to effectively scale-up triple elimination efforts and reach targets.

The novel Four Pillars Framework for Triple Elimination Implementation to guide country-led planning and implementation is aligned with the GHSS on HIV, viral hepatitis and sexually transmitted infections 2022−2030. The overarching goal of the framework is to support countries in operationalizing the move from single (HIV) and dual elimination (HIV and syphilis) to triple elimination of HIV, syphilis and HBV. This represents a major revision and modification of the 2002 UN “four-pronged strategy” for the elimination of new HIV infections among children and keeping their mother alive to include two additional conditions − syphilis and HBV − and reflects the significant updates that have been made to WHO’s technical recommendations and guidelines in the past decade.

The Four Pillars Framework focuses on distinct target populations and comprises a minimum package of essential services for each pillar:
(1) primary prevention of infection and vertical transmission
(2) SRH linkages and integration
(3) essential maternal EMTCT services and
(4) infant, child and partner services.