Review examines how donor funding disruptions affect children’s HIV care in Africa
Nine studies linked donor transitions with interruptions in staffing, supplies, outreach, testing, treatment starts and ongoing care.
Moderate evidenceReviewInterpret with caution
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
The review reported associations between donor transitions and reductions in the health workforce, supply-chain problems, and the loss of some community outreach programmes. These changes were linked with delays in early infant diagnosis, weaker connections to care, interruptions in starting antiretroviral treatment, and lower retention in care.
The researchers described these effects as connected health-system problems rather than isolated failures of individual programmes. They concluded that many paediatric HIV services remain dependent on external funding and that transition planning has often been limited.
What the review covered
Researchers conducted a scoping review following PRISMA-ScR reporting guidance. They searched for studies published between January 2005 and November 2025 that addressed how donor funding disruptions affected paediatric HIV services in sub-Saharan Africa. Nine studies were included, and findings were organised around the paediatric HIV care cascade, including diagnosis, linkage to care, treatment initiation and retention. The abstract does not specify the designs, locations or participant numbers for each included study.
What the review concluded
Across the nine included studies, donor transitions were associated with workforce reductions, supply-chain disruptions and the elimination or weakening of community-based outreach. These changes were also linked with delays in early infant diagnosis, weaker linkage to care, disruptions in antiretroviral treatment initiation and declines in retention. The review described these findings as occurring through interconnected health-system pathways. Because this was a scoping review of existing studies, the findings show reported associations and patterns; they do not by themselves prove that funding changes caused each outcome.
Who this may apply to
The findings are most relevant to paediatric HIV programmes and health systems in sub-Saharan African settings that rely substantially on external donor funding, especially during donor transitions. They should not automatically be applied to every country, programme or funding change, because the included studies may have covered only particular settings. The review does not provide evidence about individual patients’ treatment choices or about paediatric HIV services outside the populations and systems represented in the nine studies.
The significance
Paediatric HIV care often depends on several connected services, including testing, treatment access, trained staff, medicine supply chains and follow-up support. Disruptions in one part of this system may coincide with problems in other parts. The review is relevant to governments, donors and health-system planners considering how services might continue during funding changes, but it does not measure the size of health effects or establish which funding arrangements would work best.
Limitations & evidence assessment
Only nine studies were included, and the abstract gives limited information about their methods, locations, populations and risk of bias. A scoping review maps available evidence and uses narrative synthesis; it does not necessarily provide a pooled estimate of effects or establish causation. The review may also reflect differences between countries and donor programmes that cannot be treated as identical. The abstract does not report detailed outcome numbers, follow-up periods or whether included studies had comparison groups, so the strength and consistency of the reported associations remain uncertain.
Why this evidence level: This was a scoping review that brought together nine studies about paediatric HIV services in sub-Saharan Africa. It used descriptive statistics and narrative synthesis rather than a pooled analysis, and the abstract provides limited information about the quality and designs of the included studies.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
AIDS and Behavior · 2026 · DOI: 10.1007/s10461-026-05320-1
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