Nearly Half of the World's Children With HIV Are Still Not on Treatment, UNAIDS Estimates Reveal

This year's World AIDS Day, on 1 December, carries a one-word theme from the United Nations HIV agency: access.

For children living with HIV, the clearest measure of it is a single figure, 55 per cent.

That is the share of children with HIV who were receiving treatment in 2025, according to UNAIDS, the agency that leads the world's response to the virus.

Among adults, the share was 79 per cent.

About 1.26 million children under 15 were living with HIV that year, according to UNICEF estimates, which means roughly 570,000 were without the daily medicine that holds the virus in check.

Finding the child comes first

Low testing is one important reason children are being left behind.

In 2025, 35 per cent of children living with HIV did not know their status, compared with 11 per cent of adults, according to UNICEF.

That means roughly one in three children living with the virus had not been diagnosed.

Among children who knew their HIV status, about 84 per cent were receiving treatment, according to UNICEF's treatment cascade estimates.

The figures suggest that the gap begins partly before treatment can start, when children living with HIV have not been identified and linked to care.

But diagnosis alone is not enough: UNICEF says substantial numbers of children who know their status are still not receiving treatment or have not achieved viral suppression.

UNICEF says countries have made some progress in expanding testing for babies exposed to HIV, but testing rates remain low.

The World Health Organization recommends testing HIV-exposed infants at 4 to 6 weeks and again at 9 months using virological tests, with further testing after breastfeeding ends.

Babies who test positive should start treatment immediately.

Timing matters most for the youngest children.

A South African clinical trial known as the Children with HIV Early Antiretroviral Therapy (CHER) study found that starting treatment in the first 12 weeks of life reduced infant mortality by 76 per cent compared with delaying treatment.

For children who receive treatment, the results can be strong.

UNICEF estimates that 85 per cent of children on treatment had achieved viral suppression in 2025, meaning the amount of HIV in their blood had been reduced to a very low level.

But because many children remain undiagnosed or untreated, only 47 per cent of all children living with HIV had achieved viral suppression, compared with 75 per cent of adults.

A gap that has barely budged

The cost of missed diagnoses and gaps in treatment is heavy.

Children under 15 account for about 3 per cent of all people living with HIV, yet they account for 11 per cent of AIDS-related deaths, according to UNICEF.

In 2025, an estimated 93,000 children acquired HIV, mainly through transmission from their mothers during pregnancy, delivery or breastfeeding.

Another 61,000 children under 15 died of AIDS-related causes.

UNICEF says the vast majority of these deaths were preventable through treatment for opportunistic infections and antiretroviral therapy.

The shortfall is not new.

UNICEF estimates that about 690,000 children under 15 were receiving treatment in 2025, up from about 440,000 in 2010.

However, the number of children receiving treatment fell by 175,000 between 2020 and 2025.

Treatment coverage has barely improved over the longer term.

In 2020, 54 per cent of children living with HIV were receiving treatment, compared with 74 per cent of adults.

By 2025, the figures had reached 55 per cent for children and 79 per cent for adults.

Although estimates can change as new data become available, the figures show that progress for children has lagged behind that for adults.

Where a child lives also matters.

About 87 per cent of children living with HIV are in sub-Saharan Africa, and the treatment gap is particularly wide in West and Central Africa.

In 2025, only 41 per cent of children living with HIV in the region were receiving treatment, compared with 75 per cent of adults.

Across countries, treatment coverage among children ranged from below 10 per cent in some countries to above 95 per cent in others.

UNICEF reports that children were ahead of adults on the treatment cascade in only two regions: South Asia and Eastern Europe and Central Asia.

Good news, shrinking money and a promise

The picture is not only a bleak one.

Since 2010, new HIV infections among children have fallen by 69 per cent, from about 300,000 to 93,000 in 2025.

However, UNAIDS says progress has stalled in recent years.

Children are also surviving into adolescence.

Nearly 110,000 children living with HIV reached the age of 15 in 2025, more than 69 per cent of them in Eastern and Southern Africa, according to UNICEF.

Across all ages, 32.1 million people were receiving HIV treatment in 2025.

Since 2010, new HIV infections have fallen by 42 per cent and AIDS-related deaths by 57 per cent.

The funding behind that progress is under pressure.

UNAIDS says external HIV financing fell by 18 per cent in 2025, the largest decline in almost two decades.

Domestic HIV funding rose during the same period, but the loss of external support threatens services that depend heavily on international financing.

The consequences could be severe if prevention, testing and treatment programmes are scaled back.

A UNICEF-UNAIDS modelling study published in 2025 estimated that, if coverage of key HIV services fell by half by 2030 and remained at that level, an additional 1.1 million children could acquire HIV and 820,000 more could die of AIDS-related causes by 2040, compared with maintaining current service coverage.

The modelling also found that achieving global targets for preventing mother-to-child transmission and treating children could avert about 410,000 new HIV infections and 520,000 AIDS-related deaths among children by 2040.

These are projections under different scenarios, not predictions of what will necessarily happen.

In June 2026, United Nations Member States adopted a new Political Declaration on HIV and AIDS.

It commits countries to reaching 40 million people with treatment by 2030, including 38 million whose HIV is virally suppressed.

For children, closing the gap will require earlier diagnosis, faster access to treatment and stronger support to keep children in care.

It will also require sustained funding for the services that help families reach testing and treatment.

These figures are estimates based on country data, not a head count.

UNICEF's central estimate is that 55 per cent of children under 15 living with HIV were receiving treatment in 2025, with an uncertainty range of 39 to 78 per cent.

The range reflects uncertainty in the estimate; it does not mean that coverage is known to vary by that amount because children have not been tested.

The central message remains clear: nearly half of children living with HIV are still not receiving treatment.

The world has the medicines and the knowledge to change that, but children must first be identified, linked to care and supported to remain on treatment.