WHO confirms teen pandemic that Dr. Chittick first predicted
in 1994 in his Harvard Doctoral thesis:
“Adolescents and AIDS: The Third Wave”
Adolescents falling through gaps in HIV services
For World AIDS Day December 1 2013, WHO launches new HIV recommendations to increase testing, counselling, treatment and care for this neglected group
Joint news release: WHO, UNICEF
25 November 2013 | Geneva – More than 2 million adolescents between the ages of 10 and 19 years are living with HIV, and many do not receive the care and support that they need to stay in good health and prevent transmission. In addition, millions more adolescents are at risk of infection. The failure to support effective and acceptable HIV services for adolescents has resulted in a 50% increase in reported AIDS-related deaths in this group compared with the 30% decline seen in the general population from 2005 to 2012.
Addressing the specific needs of adolescents
The WHO recommendations “HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV” are the first to address the specific needs of adolescents both for those living with HIV as well as those who are at risk of infection. They are being released in advance of World AIDS Day 2013 (1 December).
“Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults,” says Dr Gottfried Hirnschall, Director of WHO HIV/AIDS Department. “Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”
“Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.” Dr Gottfried Hirnschall, Director of WHO HIV/AIDS Department. Across sub-Saharan Africa, many who were infected at birth are becoming adolescents. In addition to the many changes associated with adolescence, they also face the challenges of living with a chronic infection: disclosing the news to friends and family and preventing transmission to sexual partners.
“Adolescent girls, young men who have sex with men, those who inject drugs or are subject to sexual coercion and abuse are at highest risk. They face many barriers, including harsh laws, inequalities, stigma and discrimination which prevent them from accessing services that could test, prevent, and treat HIV,” says Craig McClure, Chief of HIV programmes for UNICEF.
“About one-seventh of all new HIV infections occur during adolescence. Unless the barriers are removed, the dream of an AIDS-free generation will never be realized.”
Making it easier to know HIV status
Furthermore, many young people do not know their HIV status. For example, in sub-Saharan Africa, it is estimated that only 10% of young men and 15% of young women (15-24 years) know their HIV status and, in other regions, although data is scarce, access to HIV testing and counseling by vulnerable adolescents is consistently reported as being very low.
WHO recommends governments review their laws to make it easier for adolescents to obtain HIV testing without needing consent from their parents. The guidelines also suggest ways that health services can improve the quality of care and social support for adolescents. And they highlight the value of involving this age group to create an adolescent-centered approach to the services that work for people of their age.
Better equipping adolescents
“Young people need to be better equipped to manage their HIV infection and take ownership of their health care,” says Dr Elizabeth Mason, Director of WHO Maternal, Newborn, Child and Adolescent Health Department. “We have seen for example in Zimbabwe that, by developing adolescent friendly services, it is possible to achieve good treatment outcomes among adolescents. We urge others to be inspired by these examples.”
To help health workers put these recommendations into practice WHO has developed a new online tool which will be launched in January 2014. It uses practical examples from country programmes that are working closely with adolescents on HIV issues.
For the UNICEF video click here
The U.N. Children’s Fund says it is alarmed about increasing HIV and AIDS rates among adolescents over the last seven years and is advocating an aggressive program that includes condom distribution and antiretroviral treatment. In a more positive development, UNICEF found that mother-to-child transmission of HIV has been dramatically reduced and estimated that some 850,000 cases were prevented in low- and middle-income countries. Its 2013 Stocktaking Report on Children and AIDS released Friday said AIDS-related deaths among those aged 10 to 19 increased between 2005 and 2012 from 71,000 to 110,000. About 2.1 million adolescents were living with HIV in 2012. Nearly 90 per cent of children newly infected with HIV live in just 22 countries. All except one are in sub-Saharan Africa. “If high-impact interventions are scaled up using an integrated approach, we can halve the number of new infections among adolescents by 2020,” said UNICEF Executive Director Anthony Lake. “It’s a matter of reaching the most vulnerable adolescents with effective programs — urgently.” High-impact interventions include:
- Antiretroviral treatment.
- Prevention of mother-to-child transmission.
- Voluntary medical male circumcision.
- Communications for behaviour change.
- Targeted approaches for at-risk and marginalized populations.
UNICEF found dramatic improvement in prevention of new HIV infections among infants. Some 260,000 children were newly infected with HIV in 2012, compared to 540,000 in 2005. New, simplified life-long antiretroviral treatment known as Option B+ provides the opportunity to effectively treat women with HIV and to prevent the transmission of the virus to their babies during pregnancy, delivery, and through breastfeeding. The treatment involves a daily one-pill regimen. Some of the most remarkable successes were in sub-Saharan Africa. New infections among infants declined between 2009 and 2012 by 76 per cent in Ghana, 58 per cent in Namibia, 55 per cent in Zimbabwe, 52 per cent in Malawi and Botswana and 50 per cent in Zambia and Ethiopia. UNICEF said that globally, the number of AIDS-related deaths overall fell by 30 per cent between 2005 and 2012.