Adolescent Prevention

This technical brief is one in a series addressing four young key populations. It is intended for policy-makers, donors, service-planners, service-providers and community-led organizations. This brief aims to catalyse and inform discussions about how best to provide health services, programmes and support for young men who have sex with men (MSM). It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young MSM; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build to the strengths, competencies and capacities of young MSM.

For adolescent boys and girls, transitioning to adulthood means facing significant social, health and economic risks. These include a lack of economic opportunities, early marriage and pregnancy, sexually transmitted infections including HIV, violence, abuse and exploitation. To support a safe, healthy and productive passage to adulthood, the Tanzania Social Action Fund (TASAF), the Tanzania Commission for AIDS (TACAIDS), UNICEF and other key stakeholders have developed, implemented and evaluated an intervention where social protection and economic empowerment interventions are combined with sexual and reproductive health education and services as part of the Tanzanian government’s cash transfer programme, the Productive Social Safety Net (PSSN).

The resources available include a project brief with a summary of the programme components and impact evaluation, as well as research briefs and reports from the baseline, midline and third wave of data collection.  

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.

A toolbox developed by and for girls and young women leaders pursuing gender justice in health and well-being for girls and young women like ourselves. It includes information and resources that we, as young women and girls, can use to strengthen our advocacy and target our service provision across multiple domains of the Sustainable Development Goals (SDGs) framework, including in HIV prevention and treatment, human rights, and sexual and reproductive health.

ALL In to #EndAdolescentAIDS

Around the world, an estimated 2.1 million adolescents between the ages of 10 and 19 years were living with HIV in 2016. Some 260,000 older adolescents (aged 15–19 years) were newly infected with HIV in 2016, or nearly  a new infection every two minutes. Nearly three out of four new infections occurred in sub-Saharan Africa. And adolescent girls continue to be disproportionately affected. Globally, nearly two thirds (65 per cent) of new HIV infections among adolescents aged 15–19 years were among girls.

Progress in preventing new infections among adolescents remains unacceptably slow, with new infections declining by only 14 per cent since 2010. Equally concerning, between 2000 and 2015, annual AIDS-related deaths declined for all age groups except adolescents (aged 10–19 years).

Demographic realities further undermine recent hopeful trends. In sub-Saharan Africa, the region most affected by HIV, the youth population has begun to explode in size and will continue to do so, with projections indicating that the number of people younger than 20 will double in 2030. That means redoubled efforts will be necessary to prevent an increase in new HIV infections among adolescents.

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.