Adolescent friendly services

Adolescent and young mothers are a priority population for UNICEF in Eastern and Southern Africa, including those who are affected by HIV. In this region, one in four women aged 20-24 years gives birth before the age of 18 years and 30 per cent of all new HIV infections occur among adolescent girls and young women aged 15-24 years. Studies increasingly show poorer maternal, child and HIV outcomes for this age group as compared to older women. Together with governments and partners, UNICEF has been working to promote differentiated, evidence-based approaches to meet the complex needs of adolescent and young mothers in several countries across the region.

This newly released report describes these efforts in nine countries, highlighting the results achieved and the learning. Key insights include the importance of responsive service delivery and social support as well as working across sectors. Also offered are ways in which policy makers, researchers, programme managers and implementers can strengthen HIV and health services for adolescent and young mothers and their children.

The AGYW Programming & Implementation Repository contains resources relevant to AGYW programming that have been collated to support enhanced implementation and programming of Global Fund Catalytic Funding for HIV prevention among AGYW in Eastern and Southern Africa. Developed in collaboration with Global Fund in response to an identified need from the SEA sub-region, we are confident that you will all find the repository useful in your support of national AGYW programmes.

The repository is housed on Google Drive and is accessible without a Gmail account. The resources are organized in folders by key programming area and are easily searchable through a google sheet. Powerpoint slides have also been developed to help you navigate through the repository.

The spreadsheet and slideshow are available for download above.

This publication primarily seeks to define and clarify the key elements of adolescent-friendly health services to help ensure that adolescents living with HIV receive appropriate and effective treatment, summarize existing guidance on adolescent-friendly health services and differentiated service delivery for adolescents living with HIV while showcasing best-practice case studies based on country experience in implementing these services.

This document is the result of collaborative work between the Department of HIV and Global Hepatitis Programme, WHO and the HIV/AIDS section, UNICEF.

This toolkit was developed by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) with funding from a consulting agreement with Johnson & Johnson, in support of the New Horizons Advancing Pediatric HIV Care Collaborative. 

The Disclosure of HIV Status Toolkit for Pediatric and Adolescent Populations provides general guidance on disclosure of HIV status in pediatric and adolescent HIV care. This document contains tools for use in clinical practice to build the capacity of health care workers, caregivers, and pediatric and adolescent patients themselves—in assisting with and delivering successful and informed disclosure. It is primarily targeted for use among health care workers.

Specific modules support:

• Health care workers or caregivers to disclose an HIV status to a child or adolescent.
• Horizontally-infected adolescents to disclose their status to their caregivers.
• Adolescents to disclose to their social networks, community, and romantic partners.

Find out more at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) website. 

WHO recommends peer support, including peer counseling, for adolescents and young people living with HIV age 10-24 years (AYPLHIV). Peer support enables providers, programs and services to be more responsive, acceptable, sustainable and relevant, encouraging AYPLHIV to seek and remain engaged in care.

Peer support activities range from support groups to peer-to-peer counseling and treatment buddy programs. Generally, AYPLHIV are formally or informally engaged as peer supporters at health facilities or in communities to provide care for and promote the health and well-being of their peers. A peer supporter can be a peer, or a near-peer (someone a few years older who understands the needs of AYPLHIV). In all cases, the aim is to ensure a source of empathic support and share positive coping strategies.

Studies show that peer support can improve AYPLHIV linkage, adherence, viral suppression, retention and psychosocial well-being. Peer support models can also provide young peer supporters with opportunities for leadership development, capacity-building and youth-led advocacy, helping to combat the negative effects of self-stigma and peer pressure.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.

Adolescents and young people (AYP) (10-24 years) are being left behind in the HIV response, with high levels of new infections, and lower levels of diagnosis and treatment coverage than adults. National and local programming adapted to their specific needs is critical to ensuring their well-being and to reaching global targets to end AIDS by 2030.

AYP, including those living with HIV and from young key populations, are not just beneficiaries of programs, but are important stakeholders and agents of change. AYP leadership and partnership is an essential component of the design, delivery and evaluation of programs that affect them, leading to better decisions and policies. In accordance with principles of the greater involvement of people living with HIV, AYP have the capacity to identify approaches and solutions that best respond to their needs, making programs more effective and helping to ensure increased uptake of services and better outcomes.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.

Urgent and ambitious 2020 global targets are on the horizon, yet there has been insufficient progress in paediatric and adolescent HIV to date. Scaling up HIV services for all children and adolescents is needed, in alignment with the UNAIDS super-fast-track framework. It’s time to make sure that nobody is left behind.

This series of 12 policy briefs by the Child Survival Working Group (CSWG) looks at scaling up key interventions for children and adolescents living with HIV. They present evidence, policy and monitoring considerations, implementation guidance and tools necessary to scale up 12 key interventions which have proven successful in identifying, linking and supporting children and adolescents to access and remain in quality care and treatment.

They are designed for program managers in government and civil society programs, particularly at country-level, and provide practical information and direction.

Learn more in the Foreword and download the briefs below. 

• Addressing the service delivery needs of children of key populations

• Strategies to improve retention of mother-baby pairs in PMTCT programs

• A child-centred approach for HIV programs

• Providing differentiated service delivery to children and adolescents

• Point-of-care testing as a solution for timely early infant diagnosis

• Complementary and connected: Engaging community and faith-based organizations to deliver PMTCT and pediatric HIV services

• Sensitizing health workers to providing responsive care for adolescents and young people living with HIV

• Family-based index case testing to identify children with HIV

• Meaningful engagement of adolescents and young people in national and local HIV programming

• Scaling up optimal antiretroviral treatment for children: A long overdue intervention

• Preventing and treating tuberculosis among children living with HIV

• Providing peer support for adolescents and young people living with HIV

The 95-95-95 targets will only be achieved with zero discrimination, including within healthcare settings. Health worker attitudes, including those of professional and lay providers, are essential in establishing the culture of a health service. Protecting confidentiality and treating adolescents and young people living with HIV (AYPLHIV) with respect are key elements of adolescent and youth-friendly health services (AYFHS). However, AYPLHIV report stigmatizing and unsupportive health worker practices, including imposed moral values, discrimination, shame and scolding and violations of confidentiality. To ensure health workers are equipped to deliver appropriate services, training and sensitization are required. While the importance of sensitization is increasingly acknowledged, a gap remains in documented interventions and models.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.