On December 1st, health care advocates around the globe recognized World AIDS Day. At the World Health Organization (WHO), this year’s event was also an opportunity to focus on adolescents living with HIV– WHO reports that over 2 million children aged 10 to 19 have the disease, and although the general population has seen a 30 percent decrease in AIDS deaths over the past seven years, amongst adolescents and teens, AIDS deaths have increased by 50 percent.
Why is AIDS becoming more and more fatal to adolescents, even as it becomes more manageable in adults? Knowing one’s HIV status is key to seeking treatment, and according to WHO, adolescents are less likely than adults to get tested for HIV. If he does not know his disease status, an HIV positive teenager won’t know to take drugs to boost his immune system, and infection, disease and death will often occur. What’s more, adolescents who are unknowingly HIV positive are more likely to engage in unsafe sex or drug use with others their own age; further spreading the disease within the adolescent demographic.
Director of the HIV/AIDS department for the World Health Organization, Dr. Gottfried Hirnschall has said that adolescents in sub-Saharan Africa, for example, cannot access HIV testing due to legal barriers, discrimination or social pressure. A teen may fear strong reprimand from her family or community if she admits to having engaged in sexual activity, so she will therefore not seek HIV testing or treatment services. Teens using illegal drugs will face a similar fear of admitting their risky activities to a health care authority.
Sexual orientation and criminalization also plays a role in HIV work amongst adolescents. Countries that punish citizens for engaging in homosexual activity should, according to WHO guidelines, reevaluate their laws so that teens (and for that matter adults) are not afraid to come forward and seek testing or treatment, regardless of the nature of their risky sexual activity. Adolescents under 18 engaging in exploitative sex work are what WHO calls a “key population,” meaning a group of people especially at risk of developing HIV or of not seeking treatment for the disease. That exploitative sex work can involve homosexual as well as heterosexual acts; another reason that WHO is encouraging legislators to rewrite laws so that teens aren’t afraid to seek medical care.
To better encourage all adolescents to get tested for HIV, WHO recommends that governments around the world valuate their health care and other legislation, and amend or create laws in order to get more children and teens to HIV testing facilities. For example, a country’s ministry of health might want to change national age-of-consent policies and allow teens to receive HIV testing or services without first supplying consent from their parents. WHO also suggests that national health organizations consider ways of supporting teens in disclosing an HIV positive status to parents and their peer community.
Children and teens may also require HIV counseling and treatment services specifically tailored to the needs of young people. This type of counseling must recognize the unique social pressures of being a young person, and offer HIV positive adolescents tools with which to reveal their disease status to others, to seek treatment and avoid illness, and to prevent further spread of the infection. Perhaps most importantly, those health care professionals offering counseling and treatment must be trained in acting non-judgmental and positive toward their young patients, or teens may be afraid to seek further medical services.
The World Health Organization is using World AIDS Day as a chance to encourage health care policy makers to more carefully consider how they can extend HIV prevention efforts toward adolescents. AIDS prevention work often focuses upon adults; those who use intravenous drugs, or engage in sexual intercourse without protection. However, preventing HIV amongst adolescents requires a different sort of action. Health care workers need to come up with ways of preventing the disease amongst sexually active or exploited teenagers; a task that might mean making sexual health services more widely available to patients in their early teens.
Educational campaigns can also be created to interest children and teenagers: community events held at nightclubs or churches to raise awareness of HIV and the importance of testing; celebrity role models who can advocate HIV testing; and use of social media. That youth-friendly focus of awareness campaigns can also be used within HIV clinics – flexible hours, lower prices and even separate waiting areas for teens might encourage more young adults to see a medical professional and discuss HIV and AIDS.