This year's World AIDS Day theme is "Take the rights path". For this occasion, UNICEF published the Eastern and Southern Africa Regional 2024 Snapshot, featuring a regional overview of HIV trends, including vertical transmission, testing, and treatment for children and adolescents, as well as gender disparities affecting adolescent girls and young women.
Eastern and southern Africa (ESA) is the world’s most heavily HIV-impacted region, with adolescent girls and young women (AGYW) disproportionately affected. To support the scale-up of PrEP amongst AGYW in ESA, in September 2021 UNICEF and partners released the implementation brief “Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa,” highlighting considerations to help improve the quality and coverage of AGYW PrEP programming.
The PrEP landscape has evolved significantly in the three years since the original brief was released, both in scale and variety. This updated brief summarises the most recent evidence on AGYW PrEP provision, serving as a supplement to the original 2021 implementation brief.
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 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.