Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Sexual and reproductive health rights of adolescents are not being met


Community AIDS activist play basketball with young people © Nell Freeman for the Alliance

The number of adolescents living with HIV is growing, particularly in low-income countries with high HIV prevalence.

Despite this, an Alliance literature review has found that the needs of young people are frequently left out of national HIV responses in low-income settings.

The review which took place as part of the DFID-funded Evidence for Action, research programme, found that services for young people often sit uncomfortably in either paediatric or adult services which are not equipped to deal with the specific needs of adolescents, (defined as the 10-19 age group by the World Health Organisation).

Regardless of whether a young person contracted HIV perinatally, as a child or as an adolescent, once a young person reaches adolescence they require adequate psychosocial care and support and HIV and sexual and reproductive health (SRH) services appropriate to their age. Currently there are large gaps in these services, which can support young people to maintain mental well-being, prepare for adult relationships, develop disclosure strategies, and adhere to treatment.

“I do not get any care and support from anyone other than my aunty. I am not part of any support group and I do not know of any support group. So my family is the only support that I have. I do not talk to anyone about how I am feeling, I keep it to myself."
Amira, 10, Lusaka, Zambia*

The only thing that I would want is to have more adults to talk to.
Julia, 10, Lusaka, Zambia*

Not by design

As health systems have not been designed to meet young people’s needs it is little surprise they experience difficulties accessing services.

Young people are less likely than adults to seek out services but when they do some of the negative experiences have included:

  • A lack of confidentiality in clinical settings
  • Judgemental attitudes of health professionals, and
  • Poor post-test counselling services

The review  highlights that change is needed on all levels, from stigma reduction at the structural and social level, to increased service capacity, and for individuals to know what services are available to them.

“Some of the services that they say are available we are not aware of them and do not know how to access them.”
Maria, 18, Lusaka, Zambia*

Significance of the review

The evidence generated from this review will strengthen the global evidence and contribute to guiding programming and advocacy efforts in this area.

It complements data from a comparative study on ‘Adolescents growing up with HIV in Southern Africa: Needs, Challenges and Opportunities’ and will help guide new policies for SRH and HIV-related services in the region.

*Quotes from a preliminary study with adolescents living with HIV in Zambia

Read the literature review in full here.

    I do not talk to anyone about how I am feeling, I keep it to myself