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Towards an AIDS-free generation Children and AIDS: Sixth Stocktaking Report, 2013

Towards an AIDS-free generation Children and AIDS: Sixth Stocktaking Report, 2013

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This Sixth Stocktaking Report focuses on the response to HIV and AIDS among children in low- and middle-income countries.1 It is structured around the first and second decades of a child’s life, and has the following objectives:
• to review the HIV burden among children and adolescents and the progress being made in
addressing it
• to identify key strategies to accelerate access to HIV prevention, treatment, protection, care and support for children and adolescents
• to summarize opportunities arising from recent
scientific advances, new technology and
emerging practice innovations
• to mobilize national and international efforts
to keep children HIV-free and ensure that those living with HIV remain AIDS-free.

While national governments are ultimately
accountable for their international and domestic commitments, this report is intended to inform the coordinated efforts of all stakeholders striving to achieve the goal of an AIDS-free generation, including donors, technical experts, United Nations organizations, implementing partners, civil society and communities in diverse settings worldwide. The involvement of adults and adolescents living with HIV is essential for the success of the strategies described in this report. Responding to HIV is a shared responsibility,and achieving an AIDS-free generation will be a shared triumph.

Throughout this report, the term ’children‘ applies to all children below the age of 18 years, including adolescents, as defined in the Convention on the Rights of the Child. The United Nations defines adolescents as persons aged 10–19 years, and young people as persons aged 15–24 years.
This Sixth Stocktaking Report focuses on the response to HIV and AIDS among children in low- and middle-income countries.1 It is structured around the first and second decades of a child’s life, and has the following objectives:
• to review the HIV burden among children and adolescents and the progress being made in
addressing it
• to identify key strategies to accelerate access to HIV prevention, treatment, protection, care and support for children and adolescents
• to summarize opportunities arising from recent
scientific advances, new technology and
emerging practice innovations
• to mobilize national and international efforts
to keep children HIV-free and ensure that those living with HIV remain AIDS-free.

While national governments are ultimately
accountable for their international and domestic commitments, this report is intended to inform the coordinated efforts of all stakeholders striving to achieve the goal of an AIDS-free generation, including donors, technical experts, United Nations organizations, implementing partners, civil society and communities in diverse settings worldwide. The involvement of adults and adolescents living with HIV is essential for the success of the strategies described in this report. Responding to HIV is a shared responsibility,and achieving an AIDS-free generation will be a shared triumph.

Throughout this report, the term ’children‘ applies to all children below the age of 18 years, including adolescents, as defined in the Convention on the Rights of the Child. The United Nations defines adolescents as persons aged 10–19 years, and young people as persons aged 15–24 years.

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Published by: The United Nations Children's Fund on Dec 02, 2013
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TOWARDS AN
 AIDS-FREE
 GENERATION
Children and AIDS
 
Sixth Stocktaking Report, 
2013
 
Stocktaking reports on children and AIDS are the flagship publications of the Unite for Children, Unite against AIDS campaign. The United Nations Children’s Fund (UNICEF) leads the development of these publications as part of its commit-ment to the Joint United Nations Programme on HIV/AIDS (UNAIDS), in collaboration with the 10 other UNAIDS co-sponsors.UNAIDS brings together the resources of the UNAIDS Secretariat and 11 United Nations system organizations for coordinated and accountable efforts to unite the world against AIDS. The division of labour is as follows:
The findings, interpretations, quotations, conclusions and opinions expressed within this report and/or on the <www.childrenandaids.org> website cannot necessarily be attributed to any individual organization involved in the production of this report.Because HIV-related stigma persists, UNICEF takes steps to safeguard the identities of children and their mothers in accordance with their wishes and with global standards of child rights and protection. UNICEF obtains written consent from people living with the virus before identifying them as such in photographs and other media. Unless otherwise stated, people depicted in this publication, and in the accompanying materials online, should not be assumed to be living with HIV.© United Nations Children’s Fund (UNICEF), 2013Permission to reproduce any part of this publication will be freely granted to educational and non-profit organizations.Suggested citation: United Nations Children’s Fund,
Towards an AIDS-Free Generation – Children and AIDS: Sixth Stocktaking Report, 2013
, UNICEF, New York, 2013. Supporting materials and data are available at: <www.childrenandaids.org>. For any corrigenda subsequent to printing, please visit the UNICEF website at <www.unicef.org/publications>.Cover photo: In northern Rwanda, children run home after school. Students took part in a discussion group that was organized to raise awareness of important social issues such as health, hygiene, sanitation and HIV. © UNICEF/RWAA2011-00631/Noorani
UNITE FOR
 
CHILDREN UNITE AGAINST
 
AIDS
 
Convening agencies
 
and partnersDivision of labour
 WHO, UNICEF,
 ILO, UNDP, UNESCO, UNFPA, UNHCR, WFP, World Bank.Prevent mothers from dying and babies from becoming infected with HIV.
 WHO,
 ILO, UNDP, UNHCR, UNICEF, WFP.Ensure that people living with HIV receive treatment.
 WHO,
 ILO, UNICEF, WFP.Prevent people living with HIV from dying of tuberculosis.
UNODC,
 UNDP, UNESCO, UNFPA, UNICEF, WHO, World Bank. Protect drug users from becoming infected with HIV and ensure access to comprehensive HIV services in prisons and closed settings.
UNDP, UNFPA,
 UNESCO, WHO, World Bank.Empower men who have sex with men, sex workers and transgender people to protect themselves and to fully access antiretroviral therapy.
UNDP,
 ILO, UNESCO, UNFPA, UNHCR, UNICEF, UNODC, UN Women, WHO.Remove punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS.
UNDP, UNFPA, UN Women,
 ILO, UNESCO, UNHCR, UNICEF, UNODC, WFP, WHO.Meet the HIV needs of women and girls, and stop sexual and gender-based violence.
UNICEF, UNFPA,
 ILO, UNESCO, UNHCR, WFP, WHO.Empower young people to protect themselves from HIV.
UNICEF, World Bank,
 ILO, UNDP, UNHCR, WFP.Enhance social protection for people affected by HIV.
UNHCR, WFP,
 UNDP, UNFPA, UNICEF, UNODC, WHO.Address HIV in humanitarian emergencies.
 WFP,
 UNHCR, UNICEF, WHO.Integrate food and nutrition within the HIV response.
UNESCO,
 ILO, UNFPA, UNICEF, WHO.Ensure high-quality education for a more effective HIV response.
 World Bank,
 ILO, UNDP, UNESCO, UNFPA, UNHCR, UNICEF, UNODC, WHO, WFP.Support strategic, prioritized and costed multi-sectoral AIDS plans.
 
CONTENTS
Executive summary: Towards an AIDS-free generation
1
About this report
ii
Chapter 1 Responding to HIV in the first decade of life
46
The first decade: Progress and challenges
15
New paradigms, opportunities and innovations
17
Strategies to accelerate progress in the first decade of life
Chapter 2 Responding to HIV in the second decade of life
2426
The second decade: Transition and vulnerability
29
Inequities and barriers to services
32
Strategies to accelerate progress in the second decade of life
39
Sustaining the gains achieved in the first decade of life
Acronyms
83
Annex: Statistical tables
5353
Notes on the data
54
Statistical table 1: Elimination of new HIV infections among children by 2015 and keeping their mothers alive
58
Statistical table 2: Providing paediatric HIV care and treatment
66
Statistical table 3: Demography and epidemiology of HIV among adolescents
70
Statistical table 4: Knowledge, HIV testing and sexual behaviour among adolescents
74
Statistical table 5: Epidemiology, knowledge, HIV testing and sexual behaviour among key affected populations aged below 25 years
78
Statistical table 6: Protection, care and support for children affected by HIV and AIDS
Chapter 3 Partnerships for an AIDS-free generation
4042
Two decades, many sectors
44
Addressing HIV among children in emergency situations: A case for enhanced partnership
45
Towards an AIDS-free generation: Addressing gaps, sustaining gains
References
46
TOWARDS AN AIDS-FREE GENERATION Children and AIDS: Sixth Stocktaking Report, 2013
Photo captions and credits
82

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