23 July 2018

Opinion piece by Anne Stagl (the International Center for Research on Women) and Caitlin Bryan (Boston University School of Public Health). 

The theme of the International AIDS Conference this week is “Breaking Barriers, Building Bridges.” While AIDS-related deaths have been declining globally and more than 20 million people living with HIV are on life-saving treatment, adolescents living with HIV continue to struggle, and few interventions are available to support their healthy transition to adulthood. Great strides have been made, but attention must be given to strategies that bridge the persistent gap between adolescence and adulthood to ensure that adolescents living with HIV can reach their full potential.  

While globally HIV incidence and AIDS-related mortality are receding, adolescents are experiencing an increase in infections and AIDS-related deaths. Of the 1.2 billion adolescents aged 10-19 globally, 2.1 million are living with HIV. In 2016, there were 260,000 adolescents between the ages of 15 and 19 who became newly infected. And adolescent girls are being hit the hardest, with HIV prevalence in some countries five times greater for 15-19 year old girls than for adolescent boys.

Adolescent girls living with HIV face significant barriers, including stigma and harmful gender norms, which often lead to isolation from their families and communities and a lack of the social support they need. This, in turn, can all negatively impact their emotional health, quality of life, and ability to adhere to antiretroviral therapy.

So, what can be done to counter these barriers? At the International Center for Research on Women, we are finding some measure of success through interventions in Lusaka, Zambia, where nearly 6 percent of girls between the ages of 15 and 19 are living with HIV. And these interventions, which prioritize structured support groups for the adolescent girls, are giving us hope that we can break through the barriers holding them back.

ICRW just completed a pilot study of an intervention called “Tikambisane,” which means “Let’s talk to each other” in Nyanga, a local Zambian language. Tikambisane is comprised of six sessions, which are focused on relationships, disclosure and stigma, antiretroviral therapy, grief and loss, and planning for the future. For most of the girls, this was their first time interacting with other adolescent girls living with HIV.

These connections provided opportunities for the girls to expand their peer networks, engage in a shared dialogue, and increase their capacity to cope. And, according to existing research, tapping into a peer social network also increases the likelihood that adolescent girls will take the medication they need regularly. The information they learned and the bonds they developed during these sessions further strengthened their resiliency and belief in their potential, giving them a greater sense of hope for the future.

Structured support groups, co-facilitated by adult counselors and peers living with HIV, hold significant promise for helping adolescent girls living with HIV to manage this challenging time in their lives. The Tikambisane intervention filled critical gaps for the adolescent girls who participated, increasing their knowledge of antiretroviral medications and of why adherence is so important. It also helped the girls develop important skills, including how and when they should disclose their HIV status, how to cope with stigma and loss, and how to plan for a successful future.

We now live in a world where it is possible for people living with HIV to live long, healthy, and fulfilling lives. But for adolescents, the barriers they face are formidable. As the 22nd International AIDS Conference quickly approaches, it is critical that we scale up effective strategies that address the unique needs of the growing number of adolescent girls — and boys — living with HIV.

Read the full article online here.