1. Rashida Ferrand rashida.ferrand@lshtm.ac.uk
Getting to the first 95 for children and adolescents: Innovative approaches for pediatric case finding IAS Satellite Session – JSI/AIDSFree Project and Partners July 23, –10 am
Rashida Ferrand

2. Dynamics of the paediatric HIV epidemic
Dramatic scale up of Prevention of mother-to-child transmission (PMTCT) programmes across Africa
PMTCT coverage variable across the region
“PMTCT” includes HIV testing of HIV-exposed infants & early infant diagnosis (EID); rates remain poor
A third of infected infants have “slow-progressing” disease―median survival 16 years: identified in older childhood
UNAIDS Global Report 2017
Wettstein C et al AIDS 2012
Ferrand RA et al AIDS 2009

3. Barriers to HIV testing in children
Supply
Demand
Ethico-legal framework
Resource competition
Language to discuss HIV
Perception of low risk
Relatively low HIV prevalence
Fragile guardianship
Disclosure of family status
Competing priorities
“Protection of child”
Kranzer K et al PloS Med 2014;
Bandason T et al AIDS Care 2013;

4. “The first 95” 95% of individuals with HIV will be diagnosed by 2030
Testing strategies have targeted infants (PMTCT) and adults
Strategies will need to take into account:
Barriers to testing in children
Physical and social heterogeneity across childhood
Dropping incidence in children