Chapter 3:

Adolescents

The global HIV epidemic among adolescents has not received enough focus. More than 100 adolescents died of AIDS every day in 2015. And the massive youth population worldwide means that redoubled efforts will be necessary to avert a rise in new HIV infections in adolescents.

Adolescent girls and young women continue to be disproportionately affected. Globally, nearly two thirds of new HIV infections among adolescents aged 15–19 years were among girls in 2015, and in sub-Saharan Africa alone, three in four new infections in 15-19 year olds are among girls. Just 26 per cent of girls in this region have comprehensive HIV knowledge.

However, new global public health commitments provide hope. If we work together to focus on prevention of new HIV infections, as well as testing and treatment, no adolescent should die an AIDS-related death – and those who are free of HIV should remain that way.

photo_Adolescent-Bangladesh_350x233.jpg
UNICEF/2014/Mawa

Progress

Increased awareness of the failure to address the HIV epidemic among adolescents has resulted in better collaboration and understanding of how to move forward. Several high-level initiatives now emphasize challenges and needs among adolescents, driving attention, resources and innovations. The UNICEF/UNAIDS-led platform, All In to #EndAdolescentAIDS, seeks to bring these together. However, progress in preventing new infections remains unacceptably slow, declining by only 8 per cent since 2009.

Challenges

The world’s fast-rising youth population further undermines recent hopeful trends, with the number of youth in Africa alone set to more than double by 2060. In addition, adolescent girls and young people continue to bear the brunt of the HIV epidemic – around the world, an estimated 1,100 young women aged 15-24 are infected with HIV every day. Adolescent key populations, such as transgender youth and men who have sex with men, are at risk in nearly every context, but experience significant barriers in access to care, mostly because of stigma and discrimination.

Strategies

There are ways we can accelerate progress for adolescents. Strengthening data collection, reaching those who rarely make use of services, and ending sexual exploitation among adolescent girls can all contribute. Knowledge – of condom use, levels of testing, perception of risk or drug use – is crucial too, and will enable us to design and deliver targeted services. We must educate adolescents to keep them and others safe, and support children as they grow, moving them onto adolescent and adult care. Crucially, HIV science moves quickly, so let’s also adapt by examining how innovations such as self-testing, mobile counseling and even using SMS to improve uptake of services can greatly support HIV prevention, treatment and care.

Conclusion

We may be proud of our progress, but the struggle is far from over. Hundreds of thousands of children are still slipping through the cracks and the world is at a critical moment in its drive to end AIDS for every child. The progress that we have made shows that enormous advances are possible. We must work together to keep achieving, especially in the places where serious inequities still exist.

An end to AIDS demands creative ways to address complex problems including stigma, lack of knowledge, poverty, gender inequality, drug and alcohol use, violence and sexual exploitation. Protection, care and support of children will underpin the world’s efforts to overcome all of them.

The day that we end AIDS is almost within sight. With strong commitment and your help, we can achieve this historic goal.