WHO

HIV Service Delivery: Safeguarding the Future. This brief was developed to inform the global dialogue and accelerate action on giving priority to services and support for adolescent and young mothers living with HIV.

This document outlines the fundamentals of PMTCT impact determination and provides considerations for development of pragmatic, streamlined and resource-efficient systems for MTCT estimate generation in high burden settings. The guidance attempts to acknowledge the current reality of PMTCT programme data and the need for reliable MTCT rates while also encouraging a forward-looking approach towards sustainable PMTCT programme data improvements.

Note that this document is intended for countries in sub-Saharan Africa with a high prevalence of HIV among women of reproductive age. Although many of the underlying principles are relevant to settings with a lower burden of HIV, the guidance is not targeted for those programmes.

The tools in appendix 2 can be accessed here.

This implementation brief examines the current efforts in eastern and southern Africa to accelerate and scale up evidence-based PrEP delivery platforms for adolescent girls and young women. The brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.

Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in eastern and southern Africa, however, they face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, but the current demand for PrEP by AGYW is low with suboptimal adherence.

Within the region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa is informed by knowledge and lessons learned emerging from a virtual thank tank and webinar convened by UNICEF together with WHO AFRO and the Global Fund, with support from the SIDA funded 2gether 4 SRHR programme, in early 2021.

L’éducation complète à la sexualité (ECS)1 est primordiale pour préparer les jeunes à une vie sûre, productive et épanouissante dans un monde où le VIH et le SIDA, les infections sexuellement transmissibles (IST), les grossesses non désirées, la violence basée sur le genre et les inégalités entre les sexes continuent de présenter des risques graves pour leur bien-être. Cependant, bien que les bienfaits d’une ECS de qualité fondée sur le programme scolaire aient été montrés de manière claire et irréfutable, peu d’enfants et de jeunes sont dotés des moyens de prendre le contrôle de leur vie et de faire, librement et de façon responsable, des choix éclairés concernant leur sexualité et leurs relations interpersonnelles.

Nombreux sont ceux qui, entrant dans l’âge adulte, ont entendu des messages contradictoires, négatifs et déroutants sur la sexualité, messages bien souvent exacerbés par la gêne et le silence des adultes, notamment des parents et des enseignants. Dans bien des sociétés, les attitudes et les lois découragent le débat public sur la sexualité et le comportement sexuel, et les normes sociales peuvent perpétuer des situations préjudiciables, telles que l’inégalité des genres dans le contexte des relations sexuelles, de la planification familiale et de l’utilisation de contraceptifs modernes.

Comprehensive sexuality education (CSE) plays a central role in the preparation of young people for a safe, productive, fulfilling life in a world where HIV and AIDS, sexually transmitted infections (STIs), unintended pregnancies, gender-based violence (GBV) and gender inequality still pose serious risks to their well-being. However, despite clear and compelling evidence for the benefits of high-quality, curriculum-based CSE, few children and young people receive preparation for their lives that empowers them to take control and make informed decisions about their sexuality and relationships freely and responsibly.

Countries are increasingly acknowledging the importance of equipping young people with the knowledge and skills to make responsible choices in their lives, particularly in a context where they have greater exposure to sexually explicit material through the Internet and other media.

This governance guidance provides clarity, consistency and detail related to the structure, function, composition and operational duties of validation committees at national, regional and global levels as an extension to what is provided in the Global guidance on the criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis. In addition, this publication describes the standardized methods for country programme review and validation of EMTCT of HIV and syphilis and PTE at these levels.

This guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV. It provides guidance to evaluate the country’s EMTCT programme, the quality and accuracy of its laboratory and data collection mechanisms, as well as its efforts to uphold human rights and equality of women living with HIV, and their involvement in decision-making processes.

International technical and programmatic guidance on out of school comprehensive sexuality education evidence-informed approach for non-formal, out-of-school programmes.

This programmatic brief explores how to expand HIV and STI prevention and contraceptive method options in contraceptive services and, thus, to reduce HIV and STI incidence among adolescent girls and women. It focuses on settings with extremely high HIV prevalence and incidence. The brief complements existing guidance on HIV prevention and sexual and reproductive health and rights (SRHR), amplifies calls for action and outlines more comprehensive approaches to integration of SRHR and HIV services. It also emphasizes the importance of SRHR for women living with HIV. It aligns with updated WHO recommendations for contraceptive eligibility for women at high risk of HIV and other HIV guidance for adolescent girls and young women.

This brief is for national programme leaders, experts and members of national working groups on HIV and STI prevention in the context of contraceptive services. It is primarily relevant in settings with very high HIV prevalence in East and Southern Africa, in other high HIV prevalence settings in sub-Saharan Africa and for women from key populations in other regions. At the same time, it proposes differentiated strategies for settings with low, medium, high and extremely high HIV prevalence among women.