Adolescents and young people represent a growing burden of people living with HIV worldwide.
Most recent data indicate that only 25 per cent of adolescent girls and 17 per cent of adolescent boys aged 15-19 in Eastern and Southern Africa — the region most affected by HIV — have been tested for HIV in the past 12 months.
Globally, in 2021, adolescent girls accounted for three-quarters of all new HIV infections among adolescents.
In sub-Saharan Africa that year, almost six times as many adolescent girls were newly infected with HIV than adolescent boys.
The Kenya HIV Estimates report of 2020 reveals that adolescents and young people account for almost half of total new infections.
Of the country's 32,017 new HIV incidents reported, 11,229 occurred among adolescents and young people aged 15 to 24.
Similarly, 30 new HIV infections occur among this group daily in Kenya.
Drawing from these statistics, the greatest tragedy is that many adolescents and young people living with HIV may not know their status.
Furthermore, boys are consistently less likely to have been tested for HIV compared to girls.
Adolescent HIV/Aids is an epidemic with a difference and its control needs to be adolescent-specific. Handling this age group comes with a lot of challenges.
They are at a very impressionable age. They are willing to experiment on anything just to fit in with their peers. Some actually fear getting pregnant more than getting infected!
Concerted efforts to address some of the issues around HIV adolescent infections must be implemented.
Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection in this population.
Of utmost importance is how to get the different interventions to work together in synergy.
A coordinated approach ought to be co-created with adolescents and would require the involvement of parents, the community and the government.
Sex education and HIV sensitisation must begin in our homes. In Kenya, most parents report having few or no discussions regarding sexuality with their children.
Mothers report experiencing sociocultural and religious inhibitions hindering them from providing meaningful sexual education to their daughters and tend to place the responsibility on teachers. This has to change.
Parents must be supported by cultural and religious bodies, to discuss sexual health at home.
Additionally, we need to introduce a robust sexual education curriculum in our schools.
Teachers in Kenya only provide basic sexual and reproductive health education on abstinence and sexually transmitted infections. This needs to change.
A comprehensive, age-appropriate and culturally relevant programme, with timetabled slots on the curriculum, must be included. Educators must be trained to give medically and factually accurate information.
They need to do so in a way that is practical and relatable.
Since youth do not get annual preventive health examinations, it is recommended that screening youth for HIV and other STIs should happen at every encounter in all healthcare settings.
Well-prepared nurses might be able to ease youth’s embarrassment and facilitate communication as well.
The information would include discussions about peer influence, knowledge and use of contraceptive methods, sexually transmitted infections and exposure to early sexual practices.
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Availability of free and effective barrier contraception methods, provided through accessible, quality-assured youth-friendly sex education services must be done.
The importance of deliberate, politically-backed and sustainable economic empowerment mechanisms for the youth cannot be overstated.
An economic empowerment approach, including providing grants to the youth, and training in life skills would make a significant difference in the lives of these HIV-infected youth.
A growing body of research shows that economic stability can mitigate against early sexual debut, unprotected sex, early pregnancy, dependence on men for economic security, transactional sex, school dropout and food insecurity.
Dr Gathu is a consultant physician and programme director, at the Department of Family Medicine, Aga Khan University Medical College, East Africa