759 - Global Pediatric Disparities in HIV Viral Load Coverage and Viral Load Suppression

Publication Number: 759.5144

Tuhin Choudhary, Tulane University School of Medicine, New Orleans, LA, United States; Jacqueline A. Firth, United States Agency for International Development, Washington, DC, United States; Troy D.. Moon, Tulane University SPHTM, New Orleans, LA, United States

Background: Children are a highly vulnerable population when it comes to HIV-related mortality and AIDS illnesses; approximately 50% children living with HIV who are not on treatment will die by the age of 2. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest governmental initiative ever established towards a single disease, combating the HIV/AIDS pandemic with programs for children and adults centering on prevention, care, and treatment, and strengthening healthcare systems.

Objective: The objective of this study was to evaluate the impact of PEPFAR interventions to improve viral load coverage (VLC) and viral load suppression (VLS) and identify any disparities between different populations of patients on ART therapy. Analyses were designed to determine differences in results between adult and pediatric populations as well as within different pediatric age groups.

Design/Methods: Publicly available PEPFAR Panorama spotlight data was used to conduct this analysis. Data and trends were compared between adult men vs adult women vs children < 15. Additionally, pediatric data was analyzed by three different age cohorts: children < 5, children aged 5-9 years, and children 10-14 years old. VLC was calculated by determining the percentage of patients eligible for viral load results who had results documented within the past 12 months. VLS was calculated by determining the percentage of ART patients with suppressed viral load results ( < 1000 copies/ml) of those who received a viral load test in the past 12 months.

Results: Trends in the overall data demonstrated significant disparities with regards to VLS and VLC between the populations. Adult men and adult women had higher VLS compared to children. VLC, however, demonstrated relatively similar rates. Within the pediatric data overall, children less than the age of 5 had lower rates of both VLC and VLS compared to children 5-9 years old and those who were 10-14 years old.

Conclusion(s): There are significant disparities when it comes to helping pediatric patients achieve optimal HIV viral load coverage and suppression in comparison to adults and even between different pediatric age groups. The data also demonstrated there was a drop in pediatric VLC in 2020 which illustrates the impact that the COVID-19 pandemic had on patients. The UN set ambitious 95-95-95 targets to end the AIDS epidemic by 2030. Initiatives like PEPFAR are critical to achieving this goal, however more efforts are needed to address and close the gaps between children and adults, and even within pediatric age groups.

Viral Load Coverage (VLC) vs Viral Load Suppression (VLS) in Adult Men vs Adult Women vs Children <15


Pediatric Viral Load Coverage (VLC) vs Viral Load Suppression (VLS)


Viral Load Coverage (VLC) vs Viral Load Suppression (VLS) in Adult Men vs Adult Women vs Children <15


Pediatric Viral Load Coverage (VLC) vs Viral Load Suppression (VLS)