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.

This implementation brief examines the current efforts in eastern and southern Africa to accelerate and scale up evidence-based PrEP delivery platforms for adolescent girls and young women. The brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.

Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in eastern and southern Africa, however, they face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, but the current demand for PrEP by AGYW is low with suboptimal adherence.

Within the region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa is informed by knowledge and lessons learned emerging from a virtual thank tank and webinar convened by UNICEF together with WHO AFRO and the Global Fund, with support from the SIDA funded 2gether 4 SRHR programme, in early 2021.

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EVIDENCE UPDATE 2024

Over the past three years, the PrEP landscape has evolved significantly including for AGYW in Eastern and Southern Africa who continue to be disproportionately affected by HIV. The evidence update titled: Pre-Exposure Prophylaxis and Adolescent Girls and Young Women in Eastern and Southern Africa: The latest insights, aims to enhance the quality and coverage of PrEP programming for AGYW. The brief, developed by AVAC, UNICEF and the Global Fund, summarizes the most recent evidence on AGYW PrEP provision and serves as a supplement to the original 2021 implementation brief.