ALL In to #EndAdolescentAIDS

Around the world, an estimated 2.1 million adolescents between the ages of 10 and 19 years were living with HIV in 2016. Some 260,000 older adolescents (aged 15–19 years) were newly infected with HIV in 2016, or nearly  a new infection every two minutes. Nearly three out of four new infections occurred in sub-Saharan Africa. And adolescent girls continue to be disproportionately affected. Globally, nearly two thirds (65 per cent) of new HIV infections among adolescents aged 15–19 years were among girls.

Progress in preventing new infections among adolescents remains unacceptably slow, with new infections declining by only 14 per cent since 2010. Equally concerning, between 2000 and 2015, annual AIDS-related deaths declined for all age groups except adolescents (aged 10–19 years).

Demographic realities further undermine recent hopeful trends. In sub-Saharan Africa, the region most affected by HIV, the youth population has begun to explode in size and will continue to do so, with projections indicating that the number of people younger than 20 will double in 2030. That means redoubled efforts will be necessary to prevent an increase in new HIV infections among adolescents.

The Optimizing HIV Treatment Access (OHTA) Initiative (2012—2017), funded by Sweden and Norway through UNICEF, supported the scale-up of lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women living with HIV. The project focused on four countries with a high HIV burden: Côte d’Ivoire, the Democratic Republic of the Congo, Malawi and Uganda. OHTA aimed to strengthen health systems to deliver lifelong treatment (also known as ‘Option B+’) for pregnant women and breastfeeding mothers living with HIV.

The three objectives of OHTA were:

1. More effective delivery of treatment for pregnant women and mothers living with HIV by strengthening the capacity of the primary health-care system;
2. Increase demand timely utilization and retention rates in prevention of mother-to-child transmission (PMTCT) services;
3. Strengthening monitoring and evaluation (M&E) efforts to improve health service delivery for pregnant and breastfeeding women living with HIV and their children.

PROMISING PRACTICES FROM THE OHTA INITIATIVE

This document from UNAIDS provides guidance on how to leverage and intensify the integration of HIV with social protection and other programmes for ending poverty and inequality. It further summarizes relevant evidence on social protection and its contribution to the AIDS response.

The HIV and social protection assessment tool is used for a quick scan of existing social protection programmes and their sensitivity (or lack of) to the HIV response in a given country and location. It provides countries and communities with tailored analysis on HIV and social protection.

UNICEF's 2021 World AIDS Day report provides global and regional statistical updates on children, adolescents and pregnant women. It further provides a brief history of the HIV epidemic and response for children together with a series of human interest stories that shine light on inequalities faced by children and adolescents, especially in HIV treatment and prevention services.

Flip through the 2021 World AIDS Day Spotlight Photo Report, which amplifies the voices of the most marginalized children, adolescents and young mothers along the theme of stolen childhood, lost adolescence. 

Building on research findings and effective interventions in low-and middle-income countries, this policy brief identifies key risks, including bullying and stigma, and facilitators, such as positive parenting and social support, that influence pathways between mental health and HIV outcomes for adolescents. It is part of a broader series that aims to support the translation of research into improved adolescent sexual reproductive health and HIV programming.

Good mental health and psychosocial wellbeing is especially important for adolescents during their transition to adulthood. It can support resilience and help initiate healthy behaviours that shape long-term positive health outcomes. Evidence shows that adolescents living with HIV are more likely to experience mental health challenges compared to their peers who do not have HIV. Poor mental health outcomes have been linked to low rates of adherence to life-saving antiretroviral treatment (ART) and retention in care.  Understanding risk factors and protective factors that influence mental health and ART adherence amongst adolescents is critical for effective programming. Within eastern and southern Africa, there is great momentum to identify and scale-up interventions that address mental health and improve treatment, care and support for adolescents living with HIV.

The COVID-19 and HIV Digest compiles news, updates, knowledge and resources related to the COVID-19 pandemic of interest to those working on HIV, health and well-being among children, adolescents and pregnant women. The digest aims to give a brief and curated overview of updates and resources each month or around specific moments. You can download individual issues here.