COMPENDIUM OF PROMISING PRACTICES of African Faith Community Interventions Against Paediatric and Adolescent HIV

UNAIDS, PEPFAR and USAID have co-published the Compendium of Promising Practices on the Role of African Faith Community Interventions to End Paediatric and Adolescent HIV. The Compendium documents 41 promising practices that provide evidence of the core roles that faith communities have played in identifying undiagnosed children living with HIV, improving continuity of treatment, supporting adolescents to access psychosocial support, care and treatment, and enabling peer support groups to empower children and adolescents living with HIV. It also documents how faith leaders have driven advocacy to tackle stigma and discrimination and pushed governments for targets to be achieved. The Compendium showcases the transformative impact of faith-based approaches, highlighting innovative strategies, programmes, and interventions that have saved lives and nurtured the well-being of young individuals. By combining the power of faith with evidence-based interventions, these organizations have created a synergy that reaches far beyond mere medical treatment. They have fostered a sense of belonging, love, and support, creating safe spaces where children and adolescents affected by HIV can find solace, guidance, and empowerment.

Click here to download the full document.

Read the summary report here.

Evidence-based practices for retention in care of mother-infant pairs in the context of eliminating mother-to-child transmission of HIV in Eastern and Southern Africa

Countries in Eastern and Southern Africa (ESA) have made remarkable progress in scaling up treatment for pregnant women living with HIV and reducing new infections among children. Estimates from the Joint United Nations Programme on HIV/AIDS indicate that 93 per cent of pregnant women living with HIV in ESA received antiretroviral medicines in 2017. Thanks to an accelerated response over the years in this region, the number of children who acquired HIV has been reduced by more than 1.2 million since 2009. This represents 80 per cent of the global reduction in new infections among children during that period.

However, one of the key challenges remaining to eliminating mother-to-child transmission of HIV is the retention of mothers and infants in care through the end of breastfeeding. Mothers and their infants in this region continue to face significant challenges as they navigate the health care system over extended periods of time.

This important review examines the bottlenecks to retention in care of mother-infant pairs and makes recommendations based on evidence-based practices to reduce those barriers.

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Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

Globally significant progress has been made in the fight to end HIV. However, rates of new infections continue to increase among 15-25 year old youth in sub-Saharan Africa. 

This study by Elona Toska, Marija Pantelic, Franziska Meinck, Katharina Keck, Roxanna Haghighat and Lucie Cluver synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.

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Integrating Mental Health and HIV Services in Zimbabwean Communities: A Nurse and Community-led Approach to Reach the Most Vulnerable

Provision of mental health services for people living with HIV is critical to provide appropriate, long-term care and support, and to improve HIV-related morbidity and mortality.

This Zimbabwe pilot study looks at the feasibility of integrating mental health and HIV stepped-care approach in nurses, community health workers, and traditional medicine practitioners. The study indicates that integration of mental health and HIV services can expand availability of mental health services for people living with HIV. 

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Policy Brief Redefining childhood vulnerability to HIV

Childhood vulnerability cuts across all development programming and planning, including the sectors of HIV and AIDS, health, child protection and social protection. Understanding indicators of childhood vulnerability in general and to HIV in particular, could help practitioners identify vulnerable children more accurately and spend money accordingly.

This policy brief by UNICEF looks at the factors indicate vulnerability for children and adolescents to HIV.

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Good Practice Guide: Adolescent HIV programming, READY – Here we come!

A greater understanding of HIV in high prevalence countries has increased awareness of the need to prioritise adolescents in HIV prevention, treatment, care and support.

This Good Practice Guide was developed by International HIV/AIDS Alliance to offer programme managers and service providers concrete implementation guidance and support as they seek to address adolescents’ needs more effectively. It is intended to shape a provider’s approach and work so that adolescents living with HIV and those from key populations can obtain the services they need and live healthy, productive lives.  

Click here to download the Good Practice Guide 

“Not Taking it Will Just be Like a Sin”: Young People Living with HIV and the Stigmatization of Less-Than-Perfect Adherence to Antiretroviral Therapy

Research by Sarah Bernays, Sara Paparini, Janet Seeley and Tim Rhodes explores young people’s perspectives and understanding on adherence to HIV antiretroviral therapy and the place of the clinics. 

Abstract

Global health priorities are being set to address questions on adherence to HIV antiretroviral therapy in adolescence. Few studies have explored young people’s perspectives on the complex host of social and relational challenges they face in dealing with their treatment in secret and their condition in silence. In redressing this, we present findings from a longitudinal qualitative study with young people living with HIV in the UK, Ireland, US, and Uganda, embedded within the BREATHER international clinical trial. Drawing from Goffman’s notion of stigma, we analyze relational dynamics in HIV clinics, as rare spaces where HIV is“known,” and how young people’s relationships may be threatened by non-adherence to treatment. Young people’s reflections on and strategies for maintaining their reputation as patients raise questions about particular forms of medicalization of HIV and the moralization of treatment adherence that affect them, and how these may restrict opportunities for care across the epidemic.

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Promising Practices in Peer Support for Adolescents and Young People Living with HIV

The principles of peer engagement are increasingly being applied to support populations of adolescents and young people living with HIV (AYPLHIV). As a critical key population of people living with, and at risk of HIV in sub-Saharan Africa, a focus on peer support is timely. This promising practice brief highlights the importance of peer-to-peer dialogue and engagement as both a significant challenge and a powerful opportunity.

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Promising Practices in Health Provider Sensitisation for Adolescents and Young People Living with HIV

While the importance of sensitising health providers to the needs of adolescents has increasingly been acknowledged, there remains a gap in documented interventions and models of practice as to how this can be actioned. This promising practice brief was developed in acknowledgement of the urgent need for operational evidence on health provider sensitisation.

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Zimbabwe Population-based HIV Impact Assessment 2015–2016: A Summary of Preliminary Findings

The Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA), a household-based national survey is the first in Zimbabwe to measure national HIV incidence and viral load suppression.  Viral suppression is greatest among older adults- over 45 years and lowest among children and young adults (0-34 yrs), especially boys. The results provide information on national and subnational progress toward control of the HIV epidemic.

Click here to download the Summary Sheet

Zimbabwe 2015 Demographic and Health Survey HIV Fact Sheet

The factsheet provides a snapshot view of HIV prevalence in Zimbabwe by age; sex; marital status and provinces. Click here to download the Factsheet

Ending Child Marriage and Stopping the Spread of HIV: Opportunities and challenges for action

This desk review by the African Union Commission and RIATT-ESA examines some of the existing literature to highlight what is known about the links between child marriage and HIV, and spotlights opportunities for further action.

Very few studies have explicitly explored the two phenomena. Given recent increases in the number of adolescent girls who are HIV-positive and the high numbers and rates of child marriage in countries with high HIV prevalence, the data do suggest a correlation between ending child marriage and stopping the spread of HIV/AIDS. Concerted action on both is undoubtedly needed. Ending child marriage should immediately be included in HIV programming, and can likely contribute to preventing, treating, stopping and eradicating HIV/AIDS. 

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HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV

Stigma shapes all aspects of HIV prevention and treatment, yet there are limited data on how HIV-infected youth and their families are affected by stigma in sub-Saharan Africa. The authors of this research conducted a qualitative study using focus group discussions among 39 HIV-infected adolescents receiving care at HIV clinics in western Kenya and 53 caregivers of HIV-infected children.

It was found that despite the high prevalence of HIV and increasing access to HIV-related services, HIV-infected adolescents and caregivers in western Kenya describe an environment in which HIV/AIDS-related stigma remains a major part of everyday life for HIV infected and affected individuals. These findings are critical to inform next steps and to move toward ending HIV/AIDS-related stigma and discrimination.

Click here to download the full research report