Significant Gaps in HIV Care for Children and Adolescents Require Urgent Attention

Pediatric HIV (search)Search disease experts are calling for urgent action to address significant gaps in HIV care for children and adolescents, as research reveals alarming disparities between pediatric and adult diagnosis rates. According to data presented at the 2025 Conference on Retroviruses and Opportunistic Infections, only 66% of children living with HIV are diagnosed compared to 91% of adult women.

Dr. Priscilla Tsondai, technical lead for the pediatric and adolescent program at the International AIDS Society (search)Search company through the Collaborative Initiative for Paediatric HIV Education and Research (search)Search term, highlighted these disparities during a session titled "Filling the Gaps: Challenges and Opportunities in the Care of Children and Youth With Perinatal HIV (search)Search disease."

Critical Disparities in Diagnosis and Treatment

Research presented on the pediatric HIV (search)Search disease testing and treatment cascade emphasized the need for improved diagnostic strategies beyond early infancy. Unlike adults, children with HIV face unique challenges that require specialized approaches to care.

"We can't really talk about gaps in treatment if we have not found those children that need to be put on treatment," Dr. Tsondai explained. She emphasized the need for "innovative and optimal testing strategies" to identify children who may not regularly visit healthcare facilities.

Early diagnosis and prompt antiretroviral therapy (search)Search drug (ART (search)Search drug) initiation are particularly critical for infants, as HIV (search)Search disease progresses more rapidly in children than adults. However, pediatric treatment involves additional complexities including negotiating with caregivers, addressing stigma, ensuring proper dosing, providing nutritional support, and continuous monitoring for co-infections such as tuberculosis (search)Search disease and pneumonia (search)Search disease.

Key Priorities for Improving Pediatric HIV Care

Dr. Tsondai outlined several urgent research gaps and priorities that need addressing:

1. Innovative Testing Strategies: Developing sustainable, community-led approaches to find undiagnosed children outside traditional healthcare settings.

2. Consent Policies and Practices: Establishing protocols that allow HIV (search)Search disease testing services for adolescents while aligning with societal values regarding sexuality and reproductive health.

3. Self-Testing Approaches: Determining effective self-testing methods appropriate for pediatric populations.

4. Adherence and Retention Interventions: Creating differentiated service delivery models that account for children's dependence on caregivers.

5. Family Support Systems: Implementing sustainable psychosocial support strategies for parents and caregivers to facilitate proper care and age-appropriate disclosure.

Adolescent-Specific Challenges

For adolescents with perinatally acquired HIV (search)Search disease, the transition to adult care presents unique challenges. Research presented at the conference examined sexual and reproductive health concerns for this population, addressing difficulties in navigating relationships, pregnancy, and healthcare access.

"What strategies or interventions can we use to support adolescents and young people that have multiple vulnerabilities?" Dr. Tsondai questioned, referring to young people who are pregnant, experiencing abuse, or living in conflict settings.

Data Tracking and Continuity of Care

A significant gap exists in tracking patient-level health data across various disease areas and throughout a patient's life course. Dr. Tsondai noted that without proper systems to monitor health data as children grow, critical information can be lost when they transition to adult care.

"The tracking of patient-level health data across various disease areas for accurate monitoring of that young person, I think it's something we still have not really managed to grasp," she said, emphasizing the need for population-level solutions beyond small research cohorts.

Changing Funding Landscape

Dr. Tsondai also acknowledged the uncertain impact of the changing funding landscape on pediatric HIV (search)Search disease response. "We do not know the full impact of the changing funding landscape in the pediatric HIV response," she cautioned, suggesting that priorities may need to be reassessed as the situation evolves.

As the global health community works to meet HIV (search)Search disease elimination targets, addressing these gaps in pediatric and adolescent HIV care remains crucial for ensuring equitable outcomes across all age groups. Experts stress that without targeted interventions for children and adolescents, progress toward ending the HIV epidemic will remain incomplete.