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.

 

Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa

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.

UNICEF’s HIV Programming in the Context of COVID-19: Building back better for children, adolescents and women

Recognizing the persistent and harmful impact that COVID-19 and related lockdown measures pose for the HIV response, governments across ESA region continue to implement interventions to sustain and further advance hard won gains toward ending AIDS. One year after the release of UNICEF's Compendium of innovative approaches to HIV programming in Eastern and Southern Africa in the context of COVID-19, this new Volume II describes results achieved in the nine countries highlighted in Volume I and shares experiences from an additional eight countries. This collective work demonstrates how countries are building upon the learning and architecture of the HIV response to proactively mitigate the impact of the COVID-19 pandemic while scaling up efforts to achieve global HIV goals, resulting in stronger responses and resilient systems for both HIV and COVID-19. Many of the adaptations and innovations described have had a positive impact beyond sustaining HIV services during COVID-19 and are demonstrating exciting opportunities to build back better with more flexible and resilient systems.

Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in Eastern and Southern Africa: A Review of the Tools in Use

This regional report aims to strengthen risk-informed programming and facilitate scale up of simple and effective tools to identify and reach those adolescent girls and young women who are most in need of services and support. All the available tools included in the review are linked in the annexes and included in UNICEF's AGYW Programming and Implementation Repository. 

 

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. 

IAS 2021 Roadmap

Download the IAS 2021 Roadmap to find sessions at the 11th International AIDS Society Conference on HIV Science relevant to HIV and children, adolescents and pregnant women.