Coming to terms with HIV in adolescence

November 2013

More than 2 million young people aged 10-19 are living with HIV. Adolescents are especially vulnerable to becoming infected with HIV and to dying from HIV-associated causes. For the first time, a WHO guideline offers advice on how to better tailor HIV services for this age group.

“I want to know what the health workers are saying to me and understand more about my HIV,” writes one adolescent girl who lives in Jamaica.

Artem, 14, sits on a wall outside
UNICEF/G. Pirozzi

“It’s my consent that should be considered, not my parents’. We should be able to get tested at a younger age,” writes another young woman in Zimbabwe.

“I think we need more youth-friendly information related to antiretroviral treatment and secondary effects. Moreover, health providers and young people need to think together on a specific timeline in our healthcare since our needs and expectations are different from adult people,” explains an adolescent boy in Mexico.

These young people living with HIV and dozens of others across the world expressed their worries and the challenges they face in a series of surveys conducted by WHO in 2011 and 2012. Their answers reveal that in many countries and settings, young people lack sufficient access to HIV testing, counselling and treatment.

Urgent need for better tailored HIV services for adolescents

Today more than 2 million young people aged 10-19 years are living with HIV. On the occasion of World AIDS Day 2013 (1 December), WHO has highlighted the urgent need for better tailored HIV services for adolescents.

"I think we need more youth-friendly information related to antiretroviral treatment and secondary effects."

An adolescent boy, Mexico

Death rates among adolescents living with HIV are not decreasing as they are in other populations. Although the global number of HIV-related deaths fell by 30% overall between 2005 and 2012, HIV-related deaths among adolescents increased by 50% during the same period.

“It is critical that countries develop better services for adolescents now and also look to the future, since over the next decade, many children who were infected with HIV at birth will enter adolescence. In addition to the physical changes and emotional ups and downs adolescents experience as they grow from children to adults, they will face the challenges of living with a chronic infection, breaking the news to the people close to them and preventing transmission,” says Jane Ferguson, a scientist in WHO’s Maternal, Newborn, Child and Adolescent Health Department.

Guidance for HIV testing and counselling and care for adolescents

In November 2013, WHO issued "HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV" - the first-ever guideline addressing the specific needs of adolescents living with HIV. It recommends that governments review their policies on consent to services in order to make it easier for adolescents to obtain HIV testing without consent from their parents. The publication also provides guidance on how health services can improve the quality of care and social support for adolescents living with HIV.

One approach that has found particular success is provision of HIV treatment and care with additional support specifically for adolescents. A recent study in Zimbabwe, published in the journal AIDS, found that 1776 youths who received treatment in such a programme were no more likely to die from HIV-associated causes than adults – contrary to the overall trend in Southern Africa and worldwide.

Young people responding to the WHO survey made it clear that being among their peers in a health care setting – and interacting with health workers who understand the unique quandaries they face – makes all the difference to them.

“Attending clinic has been easy,” wrote one young woman from Kenya in response to the WHO survey. “We have an adolescent specific day and friendly health care providers.”