May 7: World AIDS Orphans Day

Manuel Van den Broucke, sports, society and politics correspondent, May 7, 2025

What is AIDS?

AIDS (acquired immunodeficiency syndrome) is the advanced stage of infection by the human immunodeficiency virus (HIV). The progressive destruction of CD4⁺ cells causes immunosuppression that leaves the body exposed to opportunistic infections (pneumocystosis, cryptococcosis, cytomegalovirus), certain cancers (Kaposi's sarcoma, non-Hodgkin's lymphomas), and severe manifestations of common illnesses. The WHO defines AIDS as when an adult has a CD4 count below 200 cells/mm³. Lifelong antiretroviral therapy (tenofovir + lamivudine/emtricitabine + dolutegravir) suppresses viral replication, partially restores immunity, and reduces mortality by 80%. The goal is to achieve an undetectable viral load in order to prevent any sexual transmission.

Epidemiologically, 39.9 million people were living with HIV at the end of 2026, including 1.4 million children and 53% women. Although 30.7 million people are now on antiretroviral therapy (ART), 630,000 AIDS-related deaths were recorded in 2024.

Preventing mother-to-child transmission

Without intervention, the cumulative risk of HIV transmission during pregnancy, childbirth and breastfeeding is estimated at 30%. This rate drops to less than 2% if the mother is on ART with an undetectable viral load. Prevention programs include prenatal screening, immediate access to antiretroviral therapy (ART) with a high genetic barrier, systematic screening for co-infections such as syphilis and hepatitis B during prenatal visits, enhanced prophylaxis for premature newborns, and monthly virological monitoring of the mother-child pair until weaning. Premature infants often receive dual antiretroviral therapy (zidovudine and nevirapine) for 6 weeks, sometimes extended to 12 weeks if the mother's viral load remains detectable.

The United Nations Political Declaration on HIV of 2021 sets the goal of ending AIDS as a public health threat by 2030, committing states to guarantee universal access to care. Financially, the American emergency plan PEPFAR, extended until March 25, 2026, remains the leading bilateral donor, despite certain temporary clauses related to accountability.