2,100,000 Number of pregnant women with HIV/AIDS 200,000Number of pregnant women receiving PMTCT 630,000Number of MTCT new infections 2,000,000Number of children needing ART 315,000Number of infections that could be averted with PMTCT 490,000Child deaths due to AIDS (under age 14) 2.7%Percent of U5M due to AIDS 7Countries where AIDS accounts for more than 10% of U5M 17%Percent of AIDS deaths among children Global estimates relevant to Pediatric AIDS (excluding high income countries)

Projections of Needs If coverage of MTCT does not increase, there will be an additional 600,000 children infected with HIV each year Even once we reach goal of 50% coverage of MTCT (assuming short course) there will be 300,000 new pediatric infections per year

1,700,000 Number of pregnant women with HIV/AIDS 86,000Number of pregnant women receiving PMTCT 550,000Number of MTCT new infections 1,900,000Children needing ART? 275,000Number of infections that could be averted with PMTCT 440,000Child deaths due to AIDS (under 14) 5.75%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In sub-Saharan Africa

50,000 Number of pregnant women with HIV/AIDS 18,000Number of pregnant women receiving PMTCT 12,500Number of MTCT new infections 50,000Children needing ART 6,700Number of infections that could be averted with PMTCT 11,000Child deaths due to AIDS (under 14) 1.68%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In Latin America - Caribbean

150,000 Number of pregnant women with HIV/AIDS 12,000Number of pregnant women receiving PMTCT 47,000Number of MTCT new infections 160,000Children needing ART 23,000Number of infections that could be averted with PMTCT 34,000Child deaths due to AIDS (under 14) 0.57%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In South/Southeast Asia

26,000 Number of pregnant women with HIV/AIDS 500Number of pregnant women receiving PMTCT 8,400Number of MTCT new infections 21,000Children needing ART 4,200Number of infections that could be averted with PMTCT 5,000Child deaths due to AIDS (under 14) 0.54%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In North Africa – Middle East

20,000Number of pregnant women with HIV/AIDS 9,000Number of pregnant women receiving PMTCT 1,500Number of MTCT new infections 8,000Children needing ART 750Number of infections that could be averted with PMTCT 900Child deaths due to AIDS (under 14) 0.25%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In Eastern Europe – Central Asia

10,300Number of pregnant women with HIV/AIDS 300Number of pregnant women receiving PMTCT 3,300Number of MTCT new infections 8,000Children needing ART 1,600Number of infections that could be averted with PMTCT 2,000Child deaths due to AIDS (under 14) 0.04%Percent of U5M due to AIDS Estimates relevant to Pediatric AIDS In East Asia - Pacific

Zambia Profile on AIDS in children 84,000 children (under 14) living with HIV/AIDS 20,000 Deaths (under 14) 9,000 under five deaths AIDS explains 11% of U5M in Zambia 48,000 pregnant women with HIV per year, 5% coverage of PMTCT

Viet Nam Profile on AIDS in children 3,000 children (under 14) living with HIV/AIDS 470 Deaths (under 14) 64,000 under five deaths from all causes AIDS explains 0.7% of U5M in Viet Nam 2,900 pregnant women with HIV per year, 1% coverage of PMTCT

Bangladesh Profile on AIDS in children 64 children (under 14) living with HIV/AIDS 40 Deaths (under 14) 40 under five deaths AIDS explains 0.02% of U5M in Bangladesh 75 pregnant women with HIV per year, 1% coverage of PMTCT?

Issues to consider Target by country, region, locale, population, etc. Relative effectiveness of improved PMTCT and ART and complementarities of the two Comparison of ART to other child interventions (e.g., bed nets, Zinc, Vitamin A, nutrition, W & S) Equity Issues, both by wealth and disease

Estimating U5M due to HIV/AIDS For generalized epidemics –Measure prevalence among pregnant women in ss sites, urban and rural –Use curve fitting to derive a best fit for urban and rural (or additional areas) –Weight curve point by population (also can adjust for under- representation in rural) to get national prevalence among pregnant women –Apply transmission probability (0.32) to get number of newly infected children each year –Apply mortality function (both AIDS and non-AIDS) to get AIDS deaths for each cohort –Use birth cohort to get deaths under five due to AIDS

Estimating U5M due to HIV/AIDS For low-level or concentrated epidemics –Develop estimate of adults based on combination of groups at higher risk (e.g., MSM, sex workers & clients, IDU) –Assume some transmission to spouses/regular partners –For each group, estimate male and female ratio so that we have an estimate of women (15-49) who are living with HIV/AIDS –Derive population prevalence for women (with age structure) –Adjust fertility rates for women HIV positive –Now have prevalence rate among pregnant women –Then same steps: apply transmission and then mortality rates