Children and adolescents living with HIV and AIDS in Sierra Leone are in dire need of emotional, social and developmental care and support.

The data below gives some context to the important work that we do.

General overview of HIV in children and adolescents

The stigma and poor understanding of HIV means that too few people in Sierra Leone use HIV testing services.

Sierra Leone has an estimated national prevalence of HIV at 1.7 percent.

• The positivity rate across the districts is high: Western Area Rural was recorded at 3.4 percent and Port Loko District at 2.5 percent.

• The UNAIDS Spectrum Report 2020 estimates there almost 80,000 people living with HIV. Of this number almost 60 percent are females and just over 10 percent are children 14 years old or younger.

• Over two percent of women aged 15–49 have HIV; this is twice the rate of men in the same age group.

• For younger age groups, HIV prevalence among young women aged 15–24 years is 1.5 percent; this is three times the rate in young men of that same age range.

Poor testing rates

These numbers are estimates. HIV testing among infants, children and adolescents is very low.

Only 25 percent of girls/young women and 12 percent of boys/young men aged 15–24 years have had an HIV test and received their results.

Infants

The data suggests we have a high positivity rate among infants. Of the 1,497 HIV-exposed children tested for Early Infant HIV Diagnosis (EID), just over 14 percent were positive.

The need for early testing and treatment

According to the UNFPA (United Nations Population Fund) Report 2018, about 8,241 children in Sierra Leone have HIV. Only 18 percent of these children are receiving lifesaving treatment.

Problems with testing in healthcare facilities

Case detection for HIV among children is one of the biggest gaps in the HIV response in the country.

There has been some progress in HIV testing services (HTS) in Sierra Leone, but almost all HIV testing is in healthcare/clinical settings. This limits the opportunities to identify HIV positive children and adolescents.

When they are diagnosed at health facilities, this is often when they are already showing symptoms. At the symptomatic stage, the antiretroviral therapy (ART) needed to treat HIV is less effective. Also, facility-based testing services do not pro-actively search for people to test.

Children (0–14 years old) and adolescents (15–19 years old) are more likely to miss facility-based HIV testing. This means they do not receive crucial early testing and treatment.

Stigma and low uptake

Children and adolescents suffer due to late diagnosis of HIV. As a result, they have worse outcomes from their delay in getting HIV treatment.

Too few people use Sierra Leone’s HIV testing services. This is due to:

• the stigma associated with HIV,

• poor knowledge about HIV, and

• a lack of health-seeking behaviour amongst the general population including children and adolescents.

The ongoing Covid-19 pandemic has also further reduced the uptake of HIV testing in the general population.

After a positive result: how we help

• If a child or adolescent tests positive, we can improve their health chances. We can use social and other support as well as antiretroviral drugs (ARVs).

• HIV/AIDS has associated opportunistic infections that need attention.

• Education, nutrition and psychosocial support are especially useful for children and adolescents. However, they and their families are often vulnerable. Because of this, the children and adolescents who need this care the most are unlikely to have access to such services.

• We have a high rate of sexual and gender-based violence (SGBV) in Sierra Leone. SGBV increases the vulnerability of children and adolescents. There are efforts to tackle SGBV but more needs to be done to empower adolescents and children. We can teach them information and life skills. They need comprehensive sexuality education that covers HIV prevention. Also, adolescents with HIV have special sexual and reproductive issues, and this needs urgent solutions.

Donate and support us

Please read more about what we do. We need sponsorship and your donations to continue to support children and adolescents in Sierra Leone who are living with, or affected by, HIV and AIDS.

Sources and more information

• UNAIDS Spectrum Report 2020

• Demographic and health survey 2019 (pdf)

• Sixth UNFPA Country Programme: Sierra Leone [2015-2019] Evaluation Report Annexures November 2018 (pdf)

• National AIDS Control Program data

• National HIV/AIDS Secretariat Sierra Leone: National Strategic plan 2021–2025