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HIV-INFECTION AMONG YOUTH
In 2010, young people aged 15–24 accounted for 42 percent of new HIV infections in people aged 15 and older1. Among young people living with HIV, nearly 80 percent (4 million) live in sub-Saharan Africa2. Despite these startling statistics, youth – including adolescents and young adults – are a critical yet often underserved and neglected age cohort for HIV and AIDS efforts globally. Reaching people with HIV prevention services when they are young – and before they have established practices that increase their risk of HIV infection – is an essential step. Another crucial step is earlier diagnosis and provision of care and treatment of HIV cases in young people, which reduce their risk of passing the virus on to others. USAID is committed to working with the global health community to achieve an AIDS-free generation.
The U.S. Agency for International Developmen’s (USAID) contributions toward an AIDS-free generation are guided by the USAID Youth in Development Policy (2012) [PDF, 1.4MB]. The policy’s goal is to improve youth’s capacities and enable their aspirations so they can contribute to and benefit from more stable, democratic and prosperous communities and nations. As with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) programming, the Youth in Development Policy recognizes the need for countries to focus their youth programming based on the cultural, epidemiologic and context-specific circumstances of their countries. The policy maintains the need to consider more integrated and cross-sectoral programming to meet the holistic needs of youth.
The PEPFAR Blueprint: Creating an AIDS-Free Generation [PDF, 2.8MB] outlines the importance of youth in comprehensive prevention, care and treatment programming. The blueprint recognizes the need for age-appropriate, evidence-based, youth-friendly programs. It further recognizes that achieving effective HIV services requires tailoring interventions to young people’s specific needs, risks and interests. USAID remains committed to supporting the blueprint’s recognition of the need to continue evaluating the impact of PEPFAR-funded youth programs to further strengthen the evidence base.
CURRENT PROGRAMMATIC HIGHLIGHTS
Active Prevention and Communication for All (PACTO) is a USAID-supported project that is working to reduce HIV prevalence in three provinces in Mozambique. PACTO’s youth activities use an evidence-based approach to reach young people with HIV prevention education and access to health and other services. PACTO is also working to create safe environments for young people in families, schools and communities.
One of its most visible youth initiatives is SensaSons, which has showcased the views of young people by inviting them to turn their own HIV messages into song lyrics for submission to a national contest. Winning lyrics are ultimately performed at a music festival. Prior to the contest, the project reached out to young people via Facebook and by visiting 33 schools and engaging 4,000 students in discussions of sex, modern lifestyles, peer pressure and the risks associated with violence/sexual abuse including HIV.
Eighteen radio stations and three TV channels will cover the festival, including the country’s largest TV station. This station is also doing a reality show, “SensaSons,” that will include interviews with winning lyricists, singers and school authorities on HIV prevention as a new normative lifestyle.
Break the Cycle
Through its Break the Cycle (BTC) model, the Dialogue on HIV and TB project targets concentrated epidemics among young injecting drug users (IDUs) in four Central Asian countries. Funded by PEPFAR through USAID, BTC seeks to reduce the initiation and exposure of young non-IDUs to the inﬂuence of current IDUs by encouraging IDUs to avoid injecting drugs or talking about the beneﬁts of injecting drugs in the presence of young non-IDUs. Given estimates that 70 percent of HIV infections are related to injecting drug use, outreach to drug users remains a critical intervention in efforts to reduce HIV infection in Central Asia.
As the number of adolescents living with HIV (ALHIV) continues to grow, the need to improve services and policies intensifies. Acting as a thought leader around ALHIV, AIDSTAR-One has provided USAID and PEPFAR ongoing technical assistance aimed at raising awareness of the youth-friendly and comprehensive care, support and treatment needs of ALHIV. Additionally, AIDSTAR-One has provided tools to support youth, caregivers, community care providers and clinicians as youth living with HIV undergo their often challenging transition from pediatric to adult services, including:
- Technical Brief: Transitioning of Care and Other Services for Adolescents Living with HIV in Sub-Saharan Africa – Offers guidance to countries and programs to provide multidisciplinary care, support and treatment services these adolescents need.
- Pediatric and Youth Disclosure Materials – Series of booklets to aid caregivers of children and ALHIV in the disclosure process. Accompanying cue cards offer guidance for health care providers to use in introducing these booklets to caregivers. Includes Teen Talk, a question and answer guide for ALHIV. Available in French, Xhosa and Portuguese.
- Toolkit: Transitioning of Care and Other Services for Adolescents Living with HIV – Toolkit to provide community care providers with a framework for supporting youth’s transition from pediatric to adult care. Outlines essential support and treatment services to best meet the multiple unique needs of this population. Toolkit currently in development. Please e-mail firstname.lastname@example.org to be notified when this toolkit is available.
Promoting Partner Reduction: Helping Young People Understand and Avoid HIV Risks from Multiple Partnerships (FHI 360, 2013) [PDF, 21.2MB]
Promoting Partner Reduction provides a set of evidence-based activities designed for youth-serving organizations to help young people learn why HIV spreads at different rates in monogamous, sequential and concurrent sexual partnerships; analyze the reasons why young people engage in multiple partnerships; develop the intention to reduce their number of sexual partners; practice skills to refuse engaging with concurrent partners; and examine the role that gender norms play in encouraging multiple partners.
Spotlight on Gender: Evidence-Based Approaches to Protecting Adolescent Girls at Risk for HIV (AIDSTAR-One, 2012)
Despite decades of investment in HIV prevention, a large and vulnerable population – adolescent girls – remains invisible, underserved and at disproportionate risk for HIV. This editorial outlines a stepwise engagement process for improving girls’ lives and reducing their HIV risk.
Training Guide for HIV Counseling and Testing for Youth: A Manual for Providers (FHI 360, 2008) [PDF, 919KB]
This guide was developed to train providers to use HIV Counseling and Testing for Youth: A Manual for Providers [PDF, 496KB]. The training guide emphasizes an integrated approach to counseling youth during HIV testing. It features interactive exercises, participant practice sessions and other training tools. Among topics covered are introduction to integrated counseling and testing services, clinical and nonclinical models of counseling and testing, major steps in providing integrated counseling and testing, an overview of sexually transmitted infections and pregnancy prevention methods, social marketing and community support for integrated youth services.
1 Adolescents, Young People and HIV Factsheet. UNAIDS 2012. [PDF, 208KB]
2 Adolescents, Young People and HIV Factsheet. UNAIDS 2012. [PDF, 208KB]
Last updated: April 22, 2015