Adolescents and young people represent a rapidly growing share of people living with HIV worldwide. In 2012 alone, 300,000 adolescents between the ages of 10 and 19 were newly infected with the virus. If current trends continue, millions more will become HIV-positive in the coming years.
As part of a global response, the UN General Assembly High-level Meeting on AIDS in 2011 reviewed progress on reversing the epidemic. A new Political Declaration on HIV/AIDS was drawn up, with the adoption of new commitments and bold new targets. One of them is to reduce sexual transmission of HIV by 50 per cent by 2015. This will not happen unless young people have the knowledge and skills to avoid risky behaviour.
HIV PREVALENCE IN ADOLESCENTS
In 2012, about 2.1 million adolescents between the ages of 10 and 19 were living with HIV worldwide. Adolescents account for about 6 per cent of all people living with HIV and about 13 per cent of new adult HIV infections. Regions with the highest numbers of HIV-positive adolescents are sub-Saharan Africa and South Asia. Of the 2.1 million adolescents infected, about 1.3 million (62 per cent) live in Eastern and Southern Africa.
Adolescent girls and young women are disproportionately affected by
HIV in sub-Saharan Africa, particularly in countries where HIV prevalence is greater than 15 per cent. In some of these countries, adolescent girls are two to three times more likely to be infected than boys of the same age group. This includes three countries where more than 80 per cent of new infections in adolescents are among girls: Gabon (89 per cent), Sierra Leone (85 per cent) and South Africa (82 per cent).
* CEE/CIS: Central and Eastern Europe and the Commonwealth of Independent States.
Source: UNICEF, Children and AIDS: Sixth stocktaking report, UNICEF, New York, 2013.
WHAT IS NEEDED TO TURN THE TIDE
To prevent the spread of new infections, adolescents and young people need accurate and relevant information about HIV, along with a safe environment in which they can talk openly about risky behaviour. This must be accompanied by access to voluntary counselling and testing, HIV education in schools, and the prevention of other sexually transmitted infections.
Greater emphasis must also be placed on reaching adolescent boys and girls with HIV preventive care and treatment programmes. Emerging evidence suggests that young people living with HIV, especially adolescents, are less likely than others to receive health care that can keep them healthy and alive. In fact, all age groups except adolescents experienced a decline in AIDS-related deaths between 2005 and 2012. Over those eight years, AIDS-related deaths among all ages fell by 30 per cent, but among adolescents aged 10 to 19, they increased by 50 per cent.
Source: UNICEF analysis of UNAIDS 2012 HIV and AIDS estimates.
According to UNAIDS estimates, HIV prevalence has fallen in many of the most severely affected countries because adolescents and young people are adopting safer sexual practices. In several countries, risky behaviour is on the decline, including the initiation of sex before age 15, sex with multiple partners and sex without condoms.
In countries with generalized epidemics, schools can be a critical venue for reaching adolescents with the information and skills they need to avoid infection. In fact, evidence shows that school-based sex education can be effective in changing the knowledge, attitudes and practices that lead to risky behaviour.
Preventing HIV in countries with low prevalence or where the epidemic is concentrated in specific populations is especially challenging since the spread of the virus is fuelled by high-risk, often stigmatized behaviour. People who engage in such behaviour tend to be young and include sex workers, people who inject drugs and men who have sex with men.
For more data and analysis on HIV and AIDS in children, see UNICEF’s Children and AIDS: Sixth stocktaking report by clicking here.
UNICEF, Children and AIDS: Sixth stocktaking report, UNICEF, New York, 2013.
UNAIDS, Report on the Global AIDS Epidemic, UNAIDS, Geneva, 2013.
UNICEF, Progress for Children: A report card on adolescents, No. 10, UNICEF New York, 2012.
UNICEF, Progress for Children: Achieving the MDGs with equity, No. 9, UNICEF New York, 2010.
UNICEF, The State of the World’s Children 2014 in Numbers: Every child counts – Revealing disparities, advancing children’s rights, UNICEF, New York, 2014.
UNICEF, The State of the World’s Children 2013: Children with disabilities, UNICEF, New York, 2013.
UNICEF, UNAIDS, UNESCO, UNFPA, ILO, WHO and The World Bank, Opportunity in Crisis: Preventing HIV from early adolescence to young adulthood, UNICEF, New York, 2011.
WHO, Global Update on HIV Treatment 2013: Results, impact and opportunities, WHO, Geneva, 2013.
WHO, UNAIDS and UNICEF, Global HIV/AIDS Response: Epidemic update and health sector progress towards universal access – Progress report 2011, UNAIDS, Geneva, 2011.
The JAIDS Supplement is a key source of evidence that will inform collective efforts towards ending the adolescent AIDS epidemic. The series presents a collection of reviews on adolescents analyzing current evidence and experience from programmes to highlight how to improve HIV-specific outcomes.
A lack of data at the country level continues to stymie an effective national response on how best to promote HIV prevention. Most countries have no or insufficient data on HIV prevalence and/or sexual behaviour trends among young people, including several countries with exceptionally high HIV prevalence in Southern Africa. This limits a more comprehensive global analysis of trends.
GLOBAL AIDS RESPONSE PROGRESS REPORTING/UNIVERSAL ACCESS
In an effort to harmonize data collection and minimize the reporting burden on countries, UNAIDS, WHO and UNICEF have developed a joint reporting tool. The tool, which has been translated into several UN languages, combines the Global AIDS Response Progress Reporting and Universal Access reporting on the health sector response to HIV/AIDS. Countries that have not yet begun using the tool are advised to download the latest version. Accompanying guidelines support countries in using the tool and provide detailed descriptions of the indicators used.
- For more information, click here.
- For Global AIDS Response Progress Reporting/Universal Access reporting guidelines, click here.
- To view the latest version of the reporting tool, click here.
- To view a list of indicators, click here.
SPECTRUM/EPP ESTIMATE MODELLING
UNAIDS, WHO and UNICEF are using Futures Institute's modelling software, Spectrum/EPP, to generate estimates, which support policy decisions concerning public health. Spectrum includes modules for HIV estimates and projectors.
NATIONALLY REPRESENTATIVE SURVEYS
Multiple Indicator Cluster Surveys (MICS), Demographic and Health Surveys (DHS), AIDS Indicator Surveys (AIS), reproductive health surveys, sexual behaviour surveys and other nationally representative surveys are currently used to collect data on HIV and AIDS.