Not long ago, it was expected that children living with HIV would not survive to adulthood. Today, children living with HIV are thriving through adolescence into adulthood, and doing so in large numbers.
Though effective antiretroviral treatment is allowing many to live long and healthy lives, living with HIV remains a complex burden for these age groups. Treatment, care and support needs are challenging and ever-changing. Focusing on clinical services alone is insufficient. Children and adolescents living with HIV have a range of other essential needs that must be supported. They require psychosocial support, sexual and reproductive health education, alcohol and substance use counseling, and information on voluntary and safe disclosure, loss, grief, and bereavement. Children and adolescents are often confronted with a multitude of emotions, questions, and concerns regarding the complexities of disclosure, their health, and their future.
PEPFAR, WHO, UNICEF, national governments, NGOs, organizations of people living with HIV, and others are working to support children living with HIV as they transition from childhood to adolescence and adulthood.
One of USAID’s foremost concerns is how best to support and address the unique health, psychological, and social needs of adolescents living with HIV as they transition into adulthood and into adult care environments. Only an estimated 15% of HIV-exposed infants are identified and in southern Africa less than 12% those between 15 and 24 years of age have been tested and know their HIV status results. USAID acknowledges the urgent need for age-appropriate HIV testing and counseling for children and youth to identify those that remain undiagnosed.
With the participation of children and adolescents living with HIV in USAID programs, we continue to better understand how best to reach adolescents with the services they need. For one, HIV remains highly stigmatized. Children and adolescents living with HIV are confronted with complex challenges regarding disclosure with their peers and even family members. They are in need of support to practice voluntary and safe disclosure, maintain treatment literacy and adherence, and have healthy relationships.
This is a historic moment in human history. We know what works in the effort to combat major killers of children and we are in a unique position to further reduce childhood all-cause mortality and virtually eliminate new pediatric HIV infections while keeping mothers healthy.
The focus on adolescents living with HIV is important to USAID and part of a greater initiative to meet the health needs of children. For fifty years, USAID has been committed to improving child health.
In June, the Child Survival Call to Action challenged the world to reduce child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. Reaching this historic target will save an additional 45 million children’s lives by 2035.
Fifty-six governments and over 100 civil society partners committed to sharpening national plans for child survival, monitoring results, and focusing greater attention on the most disadvantaged and vulnerable children.
For children and adolescents living with HIV, we must manage their care with the desire and actions that show their self-worth including treatment and clinic adherence. And let’s continue to prioritize meeting essential needs so children and adolescents can make a healthy transition into adulthood and a fruitful, productive life thereafter.
Join the USAID-sponsored International AIDS Society satellite: Journey of Life for Children Living with HIV – From Diagnosis to Adulthood Sunday, July 22, 2012 from 9:00-11:00.