HIV and Specific Populations

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HIV and Children and Adolescents

Last Reviewed: May 4, 2017

Key Points

  • HIV can pass from an HIV-infected mother to her child during pregnancy, childbirth, or breastfeeding. Most adolescents who get HIV are infected through sex.
  • Because children and adolescents with HIV are still growing, dosing of HIV medicines is often based on weight or stage of development instead of age.
  • Medication adherence can be especially difficult for children and adolescents. For example, adolescents may skip HIV medicine doses to avoid disclosing their HIV-positive status.

Does HIV affect children and adolescents?

Yes, children and adolescents are among the people living with HIV in the United States.

  • According to the Centers for Disease Control and Prevention (CDC), 120 children younger than 13 years of age were diagnosed with HIV in 2015 in the United States.
  • CDC reports that youth 13 to 24 years of age accounted for more than 1 in 5 new HIV diagnoses in the United States in 2015. Most new HIV infections among youth occur among gay and bisexual males, with young black/African American and Hispanic/Latino gay and bisexual males especially affected.

How do children become infected with HIV?

HIV can pass from an HIV-infected mother to her child during pregnancy, childbirth, or breastfeeding.

Fortunately, HIV-infected women can take HIV medicines during pregnancy and childbirth to prevent mother-to-child transmission of HIV. In addition, babies born to HIV-infected women receive HIV medicine for 4 to 6 weeks after birth. The HIV medicine protects the babies from any HIV that may have passed from mother to child during childbirth.

Although rare, there are reports of some infants and children becoming infected with HIV by eating food that was previously chewed by a person with HIV. To be safe, infants and children should not be fed pre-chewed food.

To learn more, read the AIDSinfo Preventing Mother-to-Child Transmission of HIV fact sheet.  

How do adolescents become infected with HIV?

Most adolescents who get HIV are infected through sex. Many of them are recently infected and don’t know that they are HIV positive.

Some HIV-infected adolescents have been living with HIV since infancy. When they were infants, they acquired HIV largely through mother-to-child transmission.

What factors increase the risk of HIV infection in adolescents?

Several factors make it challenging to prevent HIV in adolescents. Many adolescents are not concerned about getting HIV. They may not take steps to prevent HIV infection, such as using condoms during sex.

The following factors also put adolescents at risk of HIV infection:

  • Sexually transmitted diseases (STDs). An STD increases the risk of getting or spreading HIV.
  • An older partner. Older partners are more likely to be infected with HIV.
  • Alcohol or drug use. Adolescents under the influence of alcohol or drugs are more likely to engage in risky behaviors, such as having sex without a condom.
  • Homelessness. Homeless adolescents who must exchange sex for money, drugs, or shelter are at high risk for HIV infection.

Is HIV treatment the same for children and adolescents living with HIV as it is for adults?

The use of HIV medicines to treat HIV infection is called antiretroviral therapy (ART). ART is recommended for everyone with HIV, including children and adolescents.

When to start ART and what HIV medicines to take depends on many factors. Growth and development are two issues that affect HIV treatment in children and adolescents.

How does growth and development affect the use of ART?

Because children and adolescents with HIV are still growing, dosing of HIV medicines is not always based on age. Instead, weight or stage of development is usually used to determine the appropriate dose of an HIV medicine.

The form of an HIV medicine to use can depend on a child’s age. For example, some HIV medicines come in a liquid form, which can make it easier for infants and young children to take their medicines.

Why can medication adherence be difficult for children and adolescents?

Medication adherence means taking HIV medicines every day and exactly as prescribed. Effective ART depends on good adherence.

Several factors can make adherence difficult for children and adolescents with HIV. For example, a child may refuse to take an HIV medicine because it tastes unpleasant.

Stigma associated with HIV can make adherence especially difficult for HIV-infected adolescents. They may skip medicine doses to avoid disclosing their HIV-positive status.

The following factors can also affect medication adherence in children and adolescents:

  • A complicated HIV regimen that includes many pills
  • A busy schedule that makes it hard to take HIV medicines on time every day
  • Mental illness or alcohol or drug abuse
  • Lack of health insurance to cover the cost of HIV medicines

The AIDSinfo fact sheet Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines includes tips on adherence. Some of the tips may be useful to children and adolescents with HIV and their parents or caregivers.

Click on the links below for more information on HIV in children and adolescents. This fact sheet is based on information from these sources.

From CDC:

From the Department of Health and Human Services:

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