Showing 1 - 20 of 28 Results for "adolescents"

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Adolescents living with HIV need information and services through adolescent-friendly HIV and contraception services. [See %{s:25}]
Provision and Access
1 study
Adolescents living with HIV need information and treatment services through adolescent-friendly HIV and family planning services. [See also %{s:25}]
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Interventions are needed to increase adherence for adolescents. Multiple studies from developed and developing countries reported young age as a risk factor for treatment interruption and that adolescents were less adherent to antiretroviral therapy than adults.
Adherence and Support
1 study
Additional research is needed on disease progression among children and adolescents who acquired HIV as infants.
Increasing Access to Services
1 study
Laws and practices that obstruct adolescents’ access to services, such as parental consent requirements, age, and marital status requirements, must be aligned with the actual behavior of adolescents. Studies found that legal requirements restricted adolescents from getting tested for HIV even if they were sexually active and at risk for HIV. "There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations aged 10 to 17 is intensified due to domestic and international legal constructs that rely on law-enforcement based interventions dependent upon arrests, pre-trial detention, incarceration and compulsory ‘rehabilitation’ in institutional placements," particularly among adolescents who sell sex or inject drugs (Conner, 2015: para 1).
Increasing Access to Services
1 study
Concerted efforts are needed to enable adolescents at risk to test confidentially for HIV and be immediately linked to services, with information on where and how to access services. Access to and update of HIV testing and counseling (HTC) by adolescents is significantly lower than for adults. One study found that adolescents who were tested through provider-initiated testing (the WHO standard) had higher loss to follow up if they tested HIV-positive than adolescents who were tested through voluntary testing and counseling (Lamb et al., 2014). HTC must, according to WHO, include consent, confidentiality, counseling, correct test results and connections to treatment, care and prevention services. A recent report found that no data exists for HTC among ages 10 to 14 (All in to End Adolescent AIDS, 2015c). Access to HTC for adolescents who inject drugs is particularly challenging. HTC clients also need counseling on contraception and referral to services.
Increasing Access to Services
1 study
While mobile phones have been shown to be effective in increasing adherence for adults on antiretroviral therapy, more implementation science research is needed on how to effectively employ mobile phones and websites for adolescent HIV prevention, treatment and care and whether adolescents have adequate access via mobile phones.
Mitigating Risk
1 study
Increased efforts are needed to reduce stigma against adolescents living with HIV, particularly young key populations. A study found that adolescents living with HIV kept silent about their HIV status to schools, friends and family so as to not experience stigma and discrimination.
Increasing Access to Services
1 study
Adolescents living with HIV need information and services through adolescent-friendly HIV services on a number of topics, including disclosure, safer sex, contraception, safe motherhood and gender-based violence. Studies found that health providers were unprepared to discuss HIV and contraception with adolescents who acquired HIV through perinatal transmission, despite the fact that significant numbers of these adolescents were already sexually active. Another study found that these adolescents need skills to disclose their serostatus to sexual partner. WHO recommends that perinatally infected adolescents be advised of their positive serostatus by age 6 (WHO, 2013) but there is little guidance on disclosure for adolescents. Facilitated disclosure by parents and providers to adolescents living with HIV may lead to higher retention in HIV care (Arrive et al., 2012). Parents living with HIV whose adolescents may be living with HIV also need assistance to disclose to their adolescents, as parents fear rejection from their children. Positive health dignity and prevention interventions can help people living with HIV lead healthy lives and reduce HIV transmission, but tailored interventions for adolescents and their parents have not been evaluated for effectiveness, although a trial is currently ongoing (Cunningham, 2015; Mofeson and Cotton, 2013). One study found that 29% of young women aged 16 to 24 living with HIV reported being forced to have sex. No validated curriculum that was shown to be effective for reducing unsafe sex among adolescents living with HIV was found, although some manuals have been developed (Parker et al., 2013c; UNESCO and GNP+, 2012).
Increasing Access to Services
1 study
Successful strategies are needed to increase adherence to ART among adolescents and reduce loss to follow up. A study found that adolescents and young adults aged 15 to 24 living with HIV were more likely, following treatment initiation, to have higher viral loads, higher rates of virological failure and greater low to follow up from services. Another study found that adolescents (ages 9 to 19) had poorer virological outcomes compared to young adults (ages 20 to 28). A review found few estimates on viral suppression among ages 10 to 19 (All in End Adolescent AIDS, 2015c). A specialized HIV management program could not retain a substantial proportion of those who tested positive for HIV in care. A review of studies of adherence among adolescents and children in Lower and Middle Income countries found that most studies were cross-sectional with age data ranging from six months to 21, limiting the ability to define which strategies are key to increasing adherence among ages 10 to 19. Cognitive behavioral therapy can be further explored as a strategy to increase adherence in adolescent populations.
Increasing Access to Services
1 study
Interventions that reduce commute times and/or ensure easy and safe access to safe public transportation may lessen the risk of sexual violence among adolescent girls. A study found that long commutes for girls increased the risk of sexual violence.
Addressing Violence Against Women
1 study
Adolescent girls who use drugs need risk reduction programs to meet their needs. A study found high rates of HIV risk behaviors among adolescent girls who use drugs, especially those who lived on the streets, as well as high rates of forced sex. Risk behaviors start at early ages (up to 30% reported being under age 15 when they first injected) (UNICEF, 2013; UNESCO, 2012c), yet younger girls who inject drugs are not being reached by existing harm reduction and HIV prevention services. Current guidelines also do not consider how best to reach adolescents (Krug et al., 2015). Age restrictions hinder adolescent access to services (Krug et al., 2015).
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Interventions to increase dual protection and dual method use are needed. Studies found that couples are reluctant to use condoms in addition to other contraceptive methods because it may symbolize distrust of a partner, particularly among adolescents.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Promoting HIV testing for male and female adolescents prior to pregnancy or fatherhood may increase those on cART prior to pregnancy, thus decreasing viral load prior to pregnancy and increasing the likelihood of reduced risk of vertical transmission
Antenatal Care - Treatment
1 study
Efforts are needed to provide HIV prevention and services to children and adolescents aged 10 to 17 who sell sex. [See also Prevention for Young People: %{s:25}] A number of studies show that significant numbers of sex workers selling sex when they are under age 18 and these adolescents are at high risk of acquiring HIV and have numerous legal and policy barriers, such as fear of the police, needing a guardian over age 18 to access HIV testing and counseling, and forced detention, in trying to access services.
Female Sex Workers
1 study
Greater efforts are needed to help young people personalize HIV risks. Studies found that knowledge about HIV prevention was superficial and that young people believed that they were not personally at risk of HIV acquisition despite risky behaviors and that condoms were not used because of “trust in partners.” Another study found that one adolescent girl reported she did not need to test for HIV as the only people at risk for acquiring HIV were those “who go to beer halls and pubs – prostitutes” (Ferrand et al., 2011). Married adolescent girls who had not become pregnant were significantly less likely to have had HIV testing and counseling (HTC) yet reported high rates of coerced sex within marriage, associated with acquiring HIV. Adolescents in one study suggested visiting hospices or people who were sick with HIV to understand more about HIV.
Mitigating Risk
1 study
Further evaluation of the potential use of Pre-exposure Prophylaxis for adolescent women is needed. PrEP has been successfully used by people who inject drugs (Choopanya et al., 2013 cited in Pettitfor et al., 2015), but no studies were found among adolescents who inject drugs. ART is being formulated in vaginal rings (Baeten et al., 2016) which may increase use by adolescents without requiring daily pill taking (Brady et al., 2013 and Tolley et al., 2013 cited in Pettitfor et al., 2015); however, the initial pilot trial showed no effcicacy for those under age 21 but efficacy for those over age 21. One study of qualitative interviews with young women found that if given the option of PrEP, they would not use condoms (Corneli et al., 2015).
Increasing Access to Services
1 study
Actions are needed to increase young people’s knowledge of when and where to access health services, including access to contraception and condoms. A UNESCO review found that young people lacked knowledge of where to access health services to meet their needs. Adolescents in numerous countries are sexually active, yet have low rates of contraceptive use. Adolescents need accurate detailed information about the level of risk of different sex acts (oral, genital and anal). Studies found that youth aged 15 to 24 were at high risk of either acquiring HIV or testing HIV-positive, yet less likely to report having been tested for HIV. Increased knowledge that HIV-positive infants can survive to adolescence is also needed so that these young people can get tested for HIV and access services. In some countries, HIV prevalence among both female and male adolescents who tested for HIV was as high as 16%. [See also Meeting the %{s:35}]
Increasing Access to Services
1 study
Interventions are needed to increase community involvement and investment in programs that promote the introduction and utilization of youth-friendly services. A literature review found that in order to increase utilization of youth friendly services, efforts to change community attitudes on adolescent sexuality were needed
Increasing Access to Services
1 study
Interventions are needed for adolescents to reduce acceptance of gender-based violence and stigma against people living with HIV. A study found high rates of stigma among adolescent girls. A nationally representative survey of youth in Tanzania found high rates of acceptance for a husband to beat his wife if she goes out without telling him; argues with him; burns food; or refuses to have sex with him. In 35% of countries with data available, more than 50% of women and men report discriminatory attitudes toward people living with HIV (UNAIDS, 2015e).
Mitigating Risk
1 study