American Academy of Pediatrics Outlines Barriers, Solutions to Improving Children’s Access to Antiretroviral Therapy for HIV

Since the 1990s, antiretroviral therapy (ART) has been effective in treating the human immunodeficiency virus (HIV) that leads to the deadly disease AIDS. Yet nationally and worldwide, infants and children younger than age 13 have less access than older children and adults. In an updated policy statement, “Increasing Access to Antiretroviral Therapy for the Prevention and Treatment of HIV in Infants, Children, and Youth in the United States,” the American Academy of Pediatrics describes barriers for different age groups and offers solutions to support patients and their caregivers facing these challenges. The policy statement, published in the August 2025 Pediatrics (online July 21), observes the challenges in administering the therapy to infants due to the need to give multiple medications, often twice daily. Growing children also require regular monitoring of labs and dose adjustment, which adds complexity and intensiveness to their HIV care. Without treatment, HIV can progress to AIDS, which can lead to serious infections and other health problems that are life-threatening.

The AAP offers recommendations, beginning with early identification and screening for HIV, as well as addressing barriers to treatment, including affordability. For newborns and infants, especially those born early or with low birth weight, the AAP supports the development of HIV medications that are safe, effective, and easy to give. Children living with HIV need medication options that are child-friendly, such as dissolvable or chewable tablets, and treatment should be easy to manage and accessible. AAP policy statements are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. To request an embargoed copy of the policy statement, contact AAP Public Affairs.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.