title: The missed HIV-positive children of Ethiopia.
abstract: OBJECTIVE
  As elsewhere, due to scarcity of data and limited awareness of HIV infection, especially in older children, the HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage is of only 12% in 2013). This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC) households.
  
  
  METHODS
  We analyzed national HIV data for Ethiopia, using Spectrum/ Estimation and Projection Package (EPP) and primary data on children living in households with at least one HIV-positive adult in the Amhara and Tigrai regions. Descriptive analysis of the age and sex distribution of HIV-positive OVC in Ethiopia was performed.
  
  
  RESULTS
  Our Spectrum/EPP analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81•6%) were aged five to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11•9% were HIV-positive, the majority of whom were between five and 10 years old with no significant difference between males and females.
  
  
  CONCLUSIONS
  There is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services.
authors: The Joint United Nations Programme on HIV/AIDS (UNAIDS), Addis Ababa, Ethiopia.
authors: Elisabetta
authors: E
authors: Pegurri
authors: Management Sciences for Health (MSH), Addis Ababa, Ethiopia.
authors: Elke
authors: E
authors: Konings
authors: Management Sciences for Health (MSH), Addis Ababa, Ethiopia.
authors: Bud
authors: B
authors: Crandall
authors: Consultant, Addis Ababa, Ethiopia.
authors: Hiwot
authors: H
authors: Haile-Selassie
authors: Save the Children, Addis Ababa, Ethiopia.
authors: Nelia
authors: N
authors: Matinhure
authors: The Joint United Nations Programme on HIV/AIDS (UNAIDS), Addis Ababa, Ethiopia.
authors: Warren
authors: W
authors: Naamara
authors: Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.
authors: Yibeltal
authors: Y
authors: Assefa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male