Mental Health and Antiretroviral Treatment Adherence among Adolescents Living with HIV 

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.

 

Start Free, Stay Free, AIDS Free: Final report on 2020 targets

In the global quest to end the AIDS epidemic as a public health threat by 2030, meeting the HIV-related needs of children, adolescents and pregnant and breastfeeding women represents a critical piece of unfinished business. To inject a sense of urgency in to global efforts to end the epidemic among children, adolescents and young women, global partners joined together in 2015 to launch the Start Free, Stay Free, AIDS Free framework. Unveiled as the global community was embracing a series of 2020 targets intended to Fast-Track the HIV response, Start Free, Stay Free, AIDS Free called for a super-Fast-Track approach to end AIDS as a public health threat among children, adolescents and young women by 2020.

Since the deadline for achieving the targets passed in December 2020, this is the final Start Free, Stay Free, AIDS Free progress report. Although the targets were global, partners identified 23 countries for intensified focus under the framework. This report specifically highlights progress against the targets in focus countries. The only focus countries outside sub-Saharan Africa (India and Indonesia) do not report data on Start Free, Stay Free, AIDS Free targets and are not covered in this report. 

UNICEF Health Results 2020: HIV and AIDS

This flyer provides a quick overview of UNICEF's results within HIV and AIDS in 2020. It describes achievements within UNICEF's main programmatic areas: prevention of mother-to-child transmission of HIV, treatment of children and adolescents living with HIV, and HIV prevention in adolescents. 

UNICEF's Global Annual Results Report - Goal Area 1 describes results achieved in more detail from p. 132-150.
 

HIV Treatment, Care, and Support for Adolescents Living with HIV in Eastern and Southern Africa: A review of interventions for scale

Adolescents in Eastern and Southern Africa (ESA) are key to achieving the global goal of ending the AIDS epidemic by 2030. ESA is home to 1.74 million adolescents living with HIV (ALHIV), representing 60 per cent of this population globally. In 12 ESA countries, AIDS is the leading cause of adolescent mortality. While there is an increasing focus on adolescents, the pace of progress remains slow, especially when compared with the growing needs of ALHIV.

It is time to deliver programmes at scale to address the needs of ALHIV, accelerating evidence of interventions producing results or showing significant promise for scale. This document examines and consolidates the current experiences of ALHIV programming in the region to support further implementation and scale-up of evidence-driven models. The findings serve as a call to action and the key considerations as a guide for governments and funding and implementing partners in scaling up service delivery to ALHIV.

Accelerating Access to Optimal Child-Friendly Antiretroviral Formulations for Children Living with HIV: Lessons Learned from Eight Sub-Saharan African Countries

EGPAF, with funding and support from Unitaid and DNDi, is bringing new-to-market pediatric ARV formulations to full-scale implementation in eight African countries. We gathered and documented lessons learned from these eight project countries to inform, streamline and accelerate the introduction and roll-out of new, child-friendly ARVs so that all children living with HIV have access to optimal, WHO-recommended treatment and care.

Operational Guidance for National Roll-Out of Family HIV Testing in West and Central Africa

HIV testing and treatment remains low among children in West and Central Africa. Various barriers prevent the scale-up of services and improved coverage for children, including limited coverage of early infant diagnostic capacity, limited decentralization of pediatric treatment including task-shifting/sharing from paediatricians to nurses and community actors, as well as prevalent HIV stigma at individual, family and community levels. Family-based HIV index testing has been identified as a game changer that can deliver quick gains for the paediatric HIV response in both high- and low prevalence settings. By using an individual family member living with HIV as an entry point to reaching the entire family unit, several underlying factors can be addressed, which limit access to HIV testing services especially for children.

This operational guidance is meant for use by national programme managers, implementers, advocates and health care providers in collaboration with partners, supported by national, regional and global experts. The guidance draws off the experience in family testing from within and outside West and Central Africa. It combines recommendations from the Dakar Expert consultation, which took place in June 2018, as well as lessons learned from the pilot of the Family Testing Operational Guidance in Liberia in June 2018. It is a living document that will be enriched as evidence on family Testing in the region grows. The use of this guidance will be complemented by a toolkit and a community of practice. It is a regional document drafted for the countries in West and Central Africa to guide country teams to design country-contextualized family HIV testing roll-out.