Adolescent friendly services

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.

This guide developed by Pediatric-Adolescent Treatment Africa (PATA) draws on lessons learned on integrating peer support strategies across several programmes in sub-Saharan Africa. It has been designed as an informative resource for the integration of peer support into HIV models of care for adolescents and young people in facility- and community-based settings. This toolkit is aimed primarily at health providers, specifically health facility managers and organizations engagement peer support programmes to strengthen health care./p>

In partnership with the Global Fund for AIDS, Tuberculosis and Malaria, UNICEF has supported the governments of Botswana and Lesotho to implement targeted programmes for adolescent girls and young women. In Lesotho, a national multi-sectoral referral framework is strengthening community-facility linkages and is catalyzing increased access to HIV/SRH services by guiding adolescent and young people to appropriate services and care. In Botswana, a radio drama series together with peer education components is tackling tough issues adolescents are facing in love, life and relationships. Documentation of both experiences are available for download.

Adolescent and young mothers are a priority population for UNICEF in Eastern and Southern Africa, including those who are affected by HIV. In this region, one in four women aged 20-24 years gives birth before the age of 18 years and 30 per cent of all new HIV infections occur among adolescent girls and young women aged 15-24 years. Studies increasingly show poorer maternal, child and HIV outcomes for this age group as compared to older women. Together with governments and partners, UNICEF has been working to promote differentiated, evidence-based approaches to meet the complex needs of adolescent and young mothers in several countries across the region.

This newly released report describes these efforts in nine countries, highlighting the results achieved and the learning. Key insights include the importance of responsive service delivery and social support as well as working across sectors. Also offered are ways in which policy makers, researchers, programme managers and implementers can strengthen HIV and health services for adolescent and young mothers and their children.

The AGYW Programming & Implementation Repository contains resources relevant to AGYW programming that have been collated to support enhanced implementation and programming of Global Fund Catalytic Funding for HIV prevention among AGYW in Eastern and Southern Africa. Developed in collaboration with Global Fund in response to an identified need from the SEA sub-region, we are confident that you will all find the repository useful in your support of national AGYW programmes.

The repository is housed on Google Drive and is accessible without a Gmail account. The resources are organized in folders by key programming area and are easily searchable through a google sheet. Powerpoint slides have also been developed to help you navigate through the repository.

The spreadsheet and slideshow are available for download above.

This publication primarily seeks to define and clarify the key elements of adolescent-friendly health services to help ensure that adolescents living with HIV receive appropriate and effective treatment, summarize existing guidance on adolescent-friendly health services and differentiated service delivery for adolescents living with HIV while showcasing best-practice case studies based on country experience in implementing these services.

This document is the result of collaborative work between the Department of HIV and Global Hepatitis Programme, WHO and the HIV/AIDS section, UNICEF.

This toolkit was developed by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) with funding from a consulting agreement with Johnson & Johnson, in support of the New Horizons Advancing Pediatric HIV Care Collaborative. 

The Disclosure of HIV Status Toolkit for Pediatric and Adolescent Populations provides general guidance on disclosure of HIV status in pediatric and adolescent HIV care. This document contains tools for use in clinical practice to build the capacity of health care workers, caregivers, and pediatric and adolescent patients themselves—in assisting with and delivering successful and informed disclosure. It is primarily targeted for use among health care workers.

Specific modules support:

• Health care workers or caregivers to disclose an HIV status to a child or adolescent.
• Horizontally-infected adolescents to disclose their status to their caregivers.
• Adolescents to disclose to their social networks, community, and romantic partners.

Find out more at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) website. 

WHO recommends peer support, including peer counseling, for adolescents and young people living with HIV age 10-24 years (AYPLHIV). Peer support enables providers, programs and services to be more responsive, acceptable, sustainable and relevant, encouraging AYPLHIV to seek and remain engaged in care.

Peer support activities range from support groups to peer-to-peer counseling and treatment buddy programs. Generally, AYPLHIV are formally or informally engaged as peer supporters at health facilities or in communities to provide care for and promote the health and well-being of their peers. A peer supporter can be a peer, or a near-peer (someone a few years older who understands the needs of AYPLHIV). In all cases, the aim is to ensure a source of empathic support and share positive coping strategies.

Studies show that peer support can improve AYPLHIV linkage, adherence, viral suppression, retention and psychosocial well-being. Peer support models can also provide young peer supporters with opportunities for leadership development, capacity-building and youth-led advocacy, helping to combat the negative effects of self-stigma and peer pressure.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.