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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Understanding the needs of adolescents living with HIV in Zambia


Chiwoko Basic School pilots sexuality and health as a regular subject on the curriculum, Zambia © Nell Fr

The impact of HIV on children and adolescents in Zambia is significant.

There are currently around 120,000 infected with HIV and 690,000 AIDS orphans. With growing numbers living with HIV there are concerns that their psychosocial, sexual health and reproductive health needs are not being met.

A qualitative study  by the International HIV/AIDS Alliance and partners in 2010 confirms that HIV support services vary in their capacity to meet the needs of young people.

Documenting the needs of HIV positive adolescents

The study, Needs, Challenges and Opportunities documented the psychosocial, sexual and reproductive health (SRH) needs of adolescents (10-19) living with HIV in Zambia and looked to identify gaps between these needs and existing SRH and HIV-related initiatives and services currently available to young people.

The study arose out of concerns that the growing number of adolescents and young people living with HIV are not receiving consistent, age-appropriate support from HIV services especially in relation to sexuality, relationships and tailoring lifestyles around their HIV status.

As antiretroviral treatment (ART) is rolled out and access becomes more viable, adolescents living with HIV require increasingly sophisticated interventions to ensure that they get the benefits of ART.


Many of the respondents are determined not to let HIV alter their lives but they face particular challenges around diagnosis and disclosure – , such as the traumatic manner in which they may discover their status –  stigma, and the need for accurate and consistent information about SRH and family planning.

The impact of social networks is strong. Effective family support assists with ART adherence and dealing with the shock of discovering their HIV status.

A number of adolescents had limited appreciation of sexual and reproductive health, and for a small number of female respondents, being in a relationship where their partner is unaware of a respondent’s HIV status mitigates opportunities for safer sex practices – the partner does not consider condom use a necessity. Additionally, being orphaned and difficulties in adhering to treatment regimes, clearly complicates what is an already difficult period in life.

Adolescent friendly resources

Though many respondents acknowledged ART clinics as life-saving, there was a significant lack of adolescent-friendly resources (though with some examples of good practice), leading to only generic counselling and support being available – which includes adults and much younger children – rather than targeted and age-specific materials and interactions. NGO, non-clinical activities on life skills and family planning were highly valued by respondents who are able to attend.

Improving life

Recommendations from the study include developing systems to ensure attendance at support groups where available, and better integration between parents/carers, and HIV services, to ensure there is seamless and consistent support.

Funding for training and resources of age-appropriate initiatives is vital. Generic programmes are ineffective and for some very intimidating as HIV support services are unable to address fully some of the special needs of this group.

With the growing numbers of adolescents living with HIV, services in all sectors need to develop robust programmes providing support, care and information for the empowerment of adolescents as they prepare for adulthood.

Funding for the study was through the Alliance Africa Regional Programme (ARP) with financial support from the Swedish development agency (SIDA). Partners to the study included Alliance Zambia, the Southern African AIDS Trust (SAT), and NZP+ (the Network of Zambian people living with HIV).

Download the 4 page study here.

    HIV complicates what is an already difficult period in life