Global, regional, and national burden of HIV among children aged 0-14 years: Estimates and socioeconomic inequalities, 1990-2021.

INTRODUCTION

Children are a priority group for HIV prevention and control. However, limited data exist regarding disease burden and temporal trends among this population. This study aimed to evaluate the burden of HIV, as well as trends in health inequalities, among children aged 0-14 years between 1990 and 2021.

METHODS

Age-standardised incidence, prevalence, disability-adjusted life years (DALYs) and death rates related to HIV among children aged 0-14 years were examined. Long-term trends and estimated annual percentage changes (EAPC) were calculated. Decomposition, health inequality, and frontier analyses were further conducted by Socio-demographic Index (SDI).

RESULTS

From 1990 to 2021, the age-standardised incidence rate (ASIR), age-standardised deaths rate (ASDR), and age-standardised DALYs rate (ASR-DALYs) of HIV among children aged 0-14 years all showed a statistically significant decline, with EAPCs of -4.60 (95% CI: -5.97, -3.21), -2.09 (95% CI: -3.74, -0.41), and -2.14 (95% CI: -3.79, -0.46), respectively. In contrast, the age-standardised prevalence rate (ASPR) increased significantly, with an EAPC of 3.16 (95% CI: 1.66, 4.68). The HIV burden was greatest among children aged 0-5 years, particularly those under 1 year. South Asia experienced the most significant increases in ASPR, ASDR, and ASR-DALYs.

CONCLUSIONS

The global HIV disease burden in children aged 0-14 years trended downward overall but remained substantial, especially in the 0-5 age group. Health inequalities persisted across SDI regions, underscoring the need for targeted public health interventions in high-burden areas, particularly South Asia.