SUMMARY: While it is unclear just how many children living with HIV are unaware of their status, evidence shows that Zimbabwe did not meet the 2020 90-90-90 target for pediatric HIV.
CLAIM: 35% of children with HIV unaware of their status’
SOURCE: ZBC
VERDICT: Inconclusive
HIV and AIDS remains a challenge in Zimbabwe, with a prevalence of 11.58 per cent translating into an estimated 1.3 million people living with HIV in 2021. Of these about 72,100 were children 0 – 14 years and 77,300 adolescents aged 10 – 19 years.
The HIV burden has come down from a high prevalence rate of 26.5 in 1997. The country has achieved the 90 90 90 goal. The 90–90–90 targets were set by UNAIDS for 2020 — 90% of people knowing their HIV status, 90% of those diagnosed with HIV on antiretroviral treatment, and 90% of those receiving treatment achieving viral suppression. Currently, 96 per cent of adults know their HIV status; 96 per cent of adults living with HIV are on treatment and 93 per cent of adults on treatment have a suppressed viral load.
The country is now working toward the 95–95–95 targets for 2025.
However, the picture might not be as rosy for children living with HIV. The national broadcaster, ZBC, in an article headlined, ‘35% of children with HIV unaware of their status’ further claims that ‘the viral load for 14 percent of those on treatment not suppressed’.
The article was also posted on their X (formerly Twitter page).
The United Nations Children’s Fund (UNICEF) reports that Zimbabwe does have a low treatment coverage rate among children living with HIV. It reports that the Antiretroviral Therapy (ART) coverage and viral suppression for children is 71% and 85% respectively, well below the national adults’ coverage of 96% and 93% respectively.
Credit: Tsvangirayi Mukwazhi/UNICEF
This means that 29% remain uncovered and 15% still have an unsuppressed viral load.
However, another UNICEF document has different figures for 2021: 73 per cent of children know their HIV status, 73 percent children living with HIV are on treatment and 58 per cent have achieved viral load suppression.
Many of the children living with HIV, and their parents or caregivers do not know the child’s HIV status. Without that knowledge,children do not receive the necessary HIV prevention, treatment, care and support services needed to stay healthy.
Guidelines on the disclosure of HIV status to minors were developed as early as 2014. These guidelines state that ‘disclosure of test results will be given to children in age-appropriate ways: Young children (usually up to 6 years of age) need to understand that they have a chronic illness that can be treated and what is involved in their care. In partnership with the parent/caregiver, the child is provided with accurate, honest information in a way that the child understands. Older children and adolescents are given all the information pertaining to his/her positive HIV status, including a full understanding of what HIV is, how it affects the body and what is involved in his/her care. It is an on-going discussion that continues as the child/adolescent matures’.
Credit: UNICEF
Despite these guidelines, a study carried out in 2019 showed that the ‘overall prevalence of disclosure in the cross-sectional sample was 66.9%. Only 26.9% of children knew how they were infected and that they can transmit the virus to others (i.e. “full disclosure”)’.
Another study showed the same trend – 29% of caregivers in the study were reluctant to broach the subject of HIV fearing the child was too young to understand.
In this 2018 study, disclosure of their positive HIV status had been made to 202 (52%) children, with a higher proportion of 11–15 year olds than 6–10 year olds being told of their HIV diagnosis (79% vs. 19%).
Conclusion
While statistics for adults living with HIV are readily available, those for children reflect the challenge facing pediatric HIV. There are conflicting figures but all point to one conclusion – that Zimbabwe is yet to hit the 90-90-90 target in pediatric HIV. The claim that 35% of children with HIV unaware of their status, has been rated as inconclusive. More resources need to be put towards the study and care of pediatric HIV.
