London School of Hygiene & Tropical Medicine

 “To end HIV/AIDS it’s crucial we start engaging with young people in sub-Saharan Africa who are affected - interventions to improve their lives needn’t be complex and costly, just sustainable, targeted and developed closely with them,” said Peter Piot, Director of the London School of Hygiene & Tropical Medicine and Handa Professor of Global Health, today, World AIDS Day.

Professor Piot’s comments were made at the launch of a new policy paper published by LSHTM and the charity Sentebale to support governments, policy makers and NGOs in tackling the continuing high levels of HIV among adolescents in sub-Saharan Africa, including those infected from birth and those infected sexually.

While great progress has been made in tackling the HIV epidemic in recent years, evidence shows adolescents have been left behind. In 2015, UNICEF reported that the number of adolescent deaths from AIDS had tripled in 15 years. UNAIDS estimates highlight that in 2016, there were 150 deaths every day amongst adolescents due to AIDS-related illnesses, and HIV remains one of the leading causes of death for adolescents in Africa. The situation is particularly urgent for adolescent girls and young women in sub-Saharan Africa. In 2015, nearly 7,500 young women aged 15–24 years acquired HIV each week.

"Working with Sentebale we’ve been able to hear first-hand the issues affecting young people affected by HIV, and improve our understanding of what they’re going through." - Peter Piot

Freely available to view or download on LSHTM’s and Sentebale’s websites, the policy paper combines the latest scientific evidence and experiences of young people in the region with HIV, to identify the barriers they face in knowing and managing their HIV status, as well as recommendations to address them. These include:

•             Recognising that adolescents living with HIV (ALHIV) face unique challenges and ensuring psychosocial support is reaching them as they transition into adulthood

•             Adopting a human rights-based approach to testing, care, virological suppression, and supporting mental wellbeing of ALHIV

•             Recognising the crucial role of caregivers, families and communities, and equipping them to best support ALHIV

•             Finding ways to sensitively discuss sex, dating and relationships for ALHIV - a clear gap in current interventions

The policy paper stems from the Sentebale Let Youth Lead Roundtable held at the School in July 2017, which was chaired by Prince Harry, the charity’s Co-Founding Patron. A key message from this meeting was the need to ensure young people with HIV are given a voice in future research and policy decisions.

Professor Peter Piot said: “The largest ever generation of adolescents in sub-Saharan Africa is at risk of HIV and yet the world is not listening to them. Working with Sentebale we’ve been able to hear first-hand the issues affecting young people affected by HIV, and improve our understanding of what they’re going through.”

The authors hope that this policy paper will help to identify not only where the scientific evidence base can be improved in the future, but how researchers, policy makers, NGOs, health workers and community networks can work together to enable young people with HIV/AIDS to live happy, healthy and productive lives.

Rashida Ferrand, Professor of International Health at the London School of Hygiene & Tropical Medicine and an author of the policy brief, said: “It’s important to recognise that young people living with HIV face unique challenges, different to adults. We must think about the meaningful involvement of young people. Undoubtedly this will lead to uncomfortable conversations as adolescents become increasingly independent and start having relationships, but they must be had - young people don’t simply live in a health clinic.”

"As a young woman living with HIV, sometimes you need motivation, sometimes challenges overwhelm you." - Masedi Kewamodimo

Cathy Ferrier, Sentebale Chief Executive Officer, said: “This paper is of crucial importance to Sentebale, and will act as a roadmap for the onward delivery of our work addressing the multitude of challenges preventing young people affected by HIV from accessing life-saving care in southern Africa. We are delighted to partner once more with the London School of Hygiene & Tropical Medicine following the Sentebale Roundtable in July, and to have the long-standing support of the Handa Foundation which makes this vital work possible.”

Sentebale Let Youth Lead Advocate, Masedi Kewamodimo, from Botswana said: “As a young woman living with HIV, sometimes you need motivation, sometimes challenges overwhelm you. Programmes like Sentebale’s Let Youth Lead are so important because it provides a structure and support network filled with peers, offering education and something that is ultimately designed for youth, by youth. It is encouraging to see so many real and every day barriers to care for our generation addressed in this paper and amplified through the relationship between LSHTM and Sentebale.”

The policy brief will be launched at HIV/AIDS in Adolescents - Needs, Opportunities and Challenges, a special event taking place at the London School of Hygiene & Tropical Medicine today, World AIDS Day.  

Organised with Sentebale and Worldwide Support for Development, the discussion event will feature Masedi Kewamodimo, a 22 year old Sentebale Let Youth Lead Advocate from Botswana who will share her story, along with perspectives from other distinguished speakers including Noerine Kaleeba, Rashida Ferrand, Cathy Ferrier and Lord Andrew Turnbull.

Publication

Addressing challenges facing adolescents in sub-Saharan Africa