Health priorities: HIV testing, treatment and care

The next few steps focus on programming for the health of adolescents and young people, considering why, as a demographic group, they’re special or different, and what we can do when developing programmes and interventions to better address their needs. To illustrate these points we’ll use the example of HIV, which ranks highly as a cause of death among adolescents globally, and is the top cause in Africa by a long way.

Where are we now?

An estimated 2.1 million adolescents were living with HIV in 2016; with 71% of these living in just 10 countries – 9 in sub-Saharan Africa, and India. This number is expected to increase in coming decades due to improved survival for people living with HIV and an increasing number of adolescents in this region.

Girls and young women are disproportionately affected by HIV, with 61% of older ALHIV (aged 15-19) being female, and 2/3 of new infections in this age group among girls. There are multiple reasons for this, including biological vulnerability (the risk of male-to-female HIV transmission is twice that of female-to-male), and gender power dynamics making it harder for young women to negotiate safe sex.

Despite the scale-up of treatment for HIV (antiretroviral therapy (ART), HIV remains an important cause of death among adolescents, and in 2015 was estimated to be the 8th leading cause of death among all adolescents globally, but the fourth leading cause in Africa. Moreover, adolescence is the only age group in which mortality from HIV is not decreasing. The video discusses why this is, and the strategies that are proving effective to improve uptake of HIV testing, and access to appropriate treatment and care. These include increased use of oral HIV self-testing kits, and availability of trained people in the community to help young people adhere to treatment.