While major advances have been made in almost every area of the response to HIV, progress for adolescents is falling behind, leaders in the global response to end the AIDS epidemic have said. Leaders from around the world met today in Nairobi, Kenya, where President Uhuru Kenyatta launched the new platform.
AIDS has become the second leading cause of death among adolescents globally. Just one in four children and adolescents under the age of 15 have access to life-saving antiretroviral treatment. Deaths are declining in all age groups, except among 10–19 year olds.
New HIV infections among adolescents are not declining as quickly as among other age groups. Adolescent girls are most affected. In South Africa, for example, more than 860 girls became infected with HIV every week in 2013, compared to 170 boys.
To address this inequity, UNAIDS, UNICEF and partners have launched ‘All In’, a new platform for action to drive better results for adolescents by encouraging strategic changes in policy and engaging more young people in the effort. Other partners include UNFPA, WHO, PEPFAR, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the MTV Staying Alive Foundation and youth movements represented by PACT and Y.
“Children and young people should be the first to benefit from the progress we have made in ending the epidemic, not the last,” said UNICEF Executive Director Anthony Lake. “We need to reach the adolescents we are missing and engage all young people in the effort to end adolescent AIDS. In fact, we cannot achieve the goal of an AIDS-free generation without them.”
HIV and AIDS in Asia Pacific
This is a pressing issue in East Asia and the Pacific. Thailand, for example, is facing a new rise in HIV and STI cases, especially among young people, with 70% of all sexually transmitted infections (STI) cases occurring in the 15-24 age group, suggesting that safer sex messages are not reaching this age group.
Despite a gradual drop in overall HIV prevalence in Thailand, new data released in 2014 showed infections have risen among groups of at-risk young people, namely those involved in sex work, those injecting drugs, and young men having unprotected sex with men.
UNICEF Thailand used this data to talk to the government about reducing the age of consent for HIV tests to below 18, providing training for health workers on working with at-risk young people, and expanding HIV education in schools. In December 2014, the official guidance on HIV tests was changed in line with our recommendation.
Working with partners, UNICEF East Asia and Pacific has produced guidance for researchers on how to obtain data about at-risk adolescents and young people, while guaranteeing their anonymity. The regional office is now working on a guidebook to help youth organisations use and understand data, in the style of a comic book.
‘All In’ to #EndAdolescentAIDS
‘All In’ focuses on four key action areas: engaging, mobilizing and empowering adolescents as leaders and actors of social change; improving data collection to better inform programming; encouraging innovative approaches to reach adolescents with essential HIV services adapted to their needs; and placing adolescent HIV firmly on political agendas to spur concrete action and mobilize resources.
HIV is the leading cause of death among adolescents in Africa and young women are most affected. This is a moral injustice. I am calling on young people to lead the ‘All In’ movement, alongside the United Nations, public and private partners, and countries themselves, to end the adolescent AIDS epidemic, said Michel Sidibé, Executive Director of UNAIDS.
Most of the 2.1 million adolescents living with HIV in 2013 became infected at least 10 years ago, when their mothers were pregnant, during delivery or in the first months of life – at a time when antiretroviral medicines that can greatly reduce the possibility of HIV transmission were not available. Many were never diagnosed, lost to follow-up or fell out of treatment and care programmes.
More than 200 young advocates and leaders from adolescent and youth movements were present at the launch of ‘All In’. Since the HIV status of many children went undiagnosed 10 to 15 years ago, they are now entering adolescence unaware that they are living with the virus, with limited opportunities for HIV detection and referral to treatment programmes.
The ‘All In’ platform for action aims to increase the meaningful participation of adolescents in decision-making processes and strengthen youth-led social movements. The campaign will also identify opportunities to link adolescent HIV strategies into existing adolescent health and development programmes. In addition, ‘All In’ will engage national leaders to coordinate, support and lead assessments of existing programmes and expand partnerships for innovation between the public and private sectors.
‘All In’ will aim to reach adolescents with HIV services designed for their specific needs and realities and to fast-track progress among an age group critical to advancing global efforts to end the AIDS epidemic by 2030.
The next five years are crucial. UNAIDS has set new Fast-Track Targets to be achieved by 2020 for adolescents that include reducing new HIV infections by at least 75%, reducing AIDS-related deaths by 65% and achieving zero discrimination. Achieving the targets would put the world on track towards ending adolescent AIDS by 2030 and ending the global AIDS epidemic as a public health threat.