Sex Transm Infect 86:ii56-ii61 doi:10.1136/sti.2010.046201
  • Supplement

Under-5 mortality due to HIV: regional levels and 1990–2009 trends

Open Access
  1. Mary Mahy1
  1. 1UNAIDS, Geneva, Switzerland
  2. 2The Futures Institute, Glastonbury, Connecticut, USA
  3. 3UNICEF, New York, USA
  1. Correspondence to Karen Stanecki, UNAIDS, 20 Avenue Appia, 1211 Geneva, 27, Switzerland; staneckik{at}
  • Accepted 7 October 2010


Background Since at least the late 1990s, HIV has been viewed as a major threat to efforts by countries to reduce under-5 mortality. Previous work has documented increased under-5 mortality due to HIV from 1990 to 1999 in Africa. The current analysis presents estimates and trends in under-5 mortality due to HIV in low- and middle-income countries by region up to 2009.

Methods The analyses are based on the national models of HIV and AIDS produced by country teams in coordination with UNAIDS and its partners for the years 1990–2009. These models produce a time series of estimates of HIV-related mortality as well as overall mortality in children aged <5 years.

Results and conclusion These analyses indicate that, in 2009, HIV accounted for roughly 2.1% (1.2–3.0%) of under-5 deaths in low- and middle-income countries and 3.6% (2.0–5.0%) in sub-Saharan Africa. The percentage of under-5 deaths due to HIV has been falling in the last decade—for example, from 2.6% (1.6–3.5%) in 2000 to 2.1% (1.2–3.0%) in 2009 in low- and middle-income countries and from 5.4% (3.3–7.3%) in 2000 to 3.6% (2.0–5.0%) in 2009 in sub-Saharan Africa. This fall in the percentage of under-5 deaths due to HIV has been driven by a combination of factors including scale-up of prevention of mother-to-child transmission programmes and treatment for pregnant women and children as well as a decrease in the prevalence of HIV among pregnant women.


  • Funding KS developed and drafted the manuscript; JD provided analytical and data coordination support; JS provided input, comments and developed Spectrum; PA and MM provided comments.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and