Adolescents

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.

This Technical Brief provides updated guidance to Global Fund applicants and implementers to leverage Global Fund financing that will further advance progress in scaling up effective programming for AGYW, in line with global partner guidance and global targets and initiatives such as the Start Free, Stay Free, AIDS Free Joint Agenda and the Global HIV Prevention Coalition Agenda.

L’éducation complète à la sexualité (ECS)1 est primordiale pour préparer les jeunes à une vie sûre, productive et épanouissante dans un monde où le VIH et le SIDA, les infections sexuellement transmissibles (IST), les grossesses non désirées, la violence basée sur le genre et les inégalités entre les sexes continuent de présenter des risques graves pour leur bien-être. Cependant, bien que les bienfaits d’une ECS de qualité fondée sur le programme scolaire aient été montrés de manière claire et irréfutable, peu d’enfants et de jeunes sont dotés des moyens de prendre le contrôle de leur vie et de faire, librement et de façon responsable, des choix éclairés concernant leur sexualité et leurs relations interpersonnelles.

Nombreux sont ceux qui, entrant dans l’âge adulte, ont entendu des messages contradictoires, négatifs et déroutants sur la sexualité, messages bien souvent exacerbés par la gêne et le silence des adultes, notamment des parents et des enseignants. Dans bien des sociétés, les attitudes et les lois découragent le débat public sur la sexualité et le comportement sexuel, et les normes sociales peuvent perpétuer des situations préjudiciables, telles que l’inégalité des genres dans le contexte des relations sexuelles, de la planification familiale et de l’utilisation de contraceptifs modernes.

Comprehensive sexuality education (CSE) plays a central role in the preparation of young people for a safe, productive, fulfilling life in a world where HIV and AIDS, sexually transmitted infections (STIs), unintended pregnancies, gender-based violence (GBV) and gender inequality still pose serious risks to their well-being. However, despite clear and compelling evidence for the benefits of high-quality, curriculum-based CSE, few children and young people receive preparation for their lives that empowers them to take control and make informed decisions about their sexuality and relationships freely and responsibly.

Countries are increasingly acknowledging the importance of equipping young people with the knowledge and skills to make responsible choices in their lives, particularly in a context where they have greater exposure to sexually explicit material through the Internet and other media.

RESPECT women: Preventing violence against women

Violence against women is a major public health problem rooted in gender inequality, and is a gross violation of women’s human rights affecting the lives and health of millions of women and girls. Aiming to end violence against women, a package/framework with infographics on prevention of violence against women - RESPECT – Preventing violence against women: A framework for policymakers, was developed, based on the UN framework for action to prevent violence against women from 2015 and updated new evidence.

• R –elationship skills strengthened
• E –mpowerment of women
• S –ervices ensured
• P –overty reduced
• E –nvironments made safe
• C –hild and adolescent abuse prevented
• T –ransformed attitudes, beliefs, and norms

Envision for Girls Data Hub

Envision for Girls is a data hub that maps programmes and highlights opportunities for realizing the well-being of adolescent girls and young women

Guidance for PEPFAR country teams on the DREAMS Partnership

This programming guidance is meant to inform programmes that aim to reduce HIV infection among adolescent girls and young women in countries and locations where HIV incidence is high among adolescent girls and young women and where HIV is primarily spread through heterosexual transmission. This report primarily is for policymakers, planners and implementers of HIV prevention programmes across multiple sectors, including organizations led by young people. The document also is useful for experts in wider health and social sector programmes, including health workers and teaching staff, or any other professionals who can integrate dimensions of HIV prevention into their area of work.

The Start Free Stay Free AIDS Free framework promotes a set of human rights-based interventions to end AIDS as a public health threat among children and adolescents. It focuses on enhancing actions in 23 countries with high numbers of children, adolescents and young women living with HIV.