Trends in under-five mortality in countries with high HIV prevalence: when will they decline again?

Michel Garenne, Institut Pasteur

With the diffusion of highly-active anti-retroviral therapies (HAART), the mortality of adults of both sexes started to decline again, after years of fast increase in African countries with high HIV prevalence, since about year 2005. However, this does not seem to be the case for under-five mortality, which continues to rise in the same countries. The study focuses on under-five mortality trends in some ten countries of sub-Saharan Africa where HIV prevalence among adults is higher than 10%. Data come from DHS surveys conducted after 2005. Trends in under-five mortality are fitted with a linear-logistic regression model. Mortality increases are compared with trends in HIV seroprevalence among pregnant women. Whenever possible, trends in under-five mortality are matched with trends in adult mortality. Reasons for this discrepancy are discussed with respect to screening and treatment of children with HIV.