Integrating Psychosocial Interventions And Support Into Hiv Services For Adolescents And Young Adults

This technical brief seeks to establish the importance of implementing psychosocial interventions to optimize HIV outcomes and support mental health for adolescents and young people living with HIV; to provide evidence included in the recent WHO guidelines to educate on how this can and has been done; and to chart a way forward for the integration of mental health and HIV services for this population. It provides approaches and examples of integration of interventions within health services.

WHO has progressively strengthened its work for adolescent health, growing its portfolio of research, norms and standards, country support and advocacy, and expanding the scope of work across over 17 departments, regional and country offices to address the multifaceted needs of the global adolescent population. Central to a coordinated approach to adolescent health across the organization is the HQ Interdepartmental Technical Working Group on Adolescent Health and Well-being. In 2021, the group produced the first report on its work on adolescent health and well-being, celebrating efforts across many areas of work and all levels of the organization. This is the second in the series of biennial reports that comes on the wake of the Global Forum for Adolescents 2023 and is powered by its 1.8 Billion Young People for Change campaign. The report describes WHO’s efforts to elevate adolescent health and well-being through collaboration and by coordinating new initiatives, addressing emerging needs and establishing ambitious objectives with its development partners and adolescents. Target audience: this WHO serial publication is designed to be used by policy-makers, media and donors.

These consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring bring together existing and new clinical and programmatic recommendations across different ages, populations and settings, bringing together all relevant WHO guidance on HIV produced since 2016. It serves as an update to the previous edition of the consolidated guidelines on HIV. These guidelines continue to be structured along the continuum of HIV care. Information on new combination prevention approaches, HIV testing, ARV regimens and treatment monitoring are included. There is a new chapter on advanced HIV disease that integrates updated guidance on the management of important HIV comorbidities, including cryptococcal disease, histoplasmosis and tuberculosis. The chapter on general HIV care, contains a new section on palliative care and pain management, and up to date information on treatment of several neglected tropical diseases, such as visceral leishmaniasis and Buruli ulcer. New recommendations for screening and treating of cervical pre-cancer lesions in women living with HIV are also addressed in this chapter. Guidance on service delivery was expanded to help the implementation and strengthening the HIV care cascade. Importantly, this guidance emphasizes the need for differentiated approaches to care for people who are established on ART, such as reduced frequency of clinic visits, use of multi-month drug dispensing and implementation of community ART distribution. The adoption of these efficiencies is essential to improve the quality of care of people receiving treatment and reduce the burden on health facilities, particularly in resource limited settings.

These guidelines provide new and updated recommendations and good practice statements in the following areas: starting ART, including initiating treatment outside the clinic and support for same-day ART start; frequency of clinical visits and ART refills; measuring adherence; tracing and re-engagement in care for all populations; psychosocial support for adolescents living with HIV; task sharing for diagnostic services; and service integration. This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030. WHO is currently in the process of collating all HIV normative guidance developed since 2016 in order to publish the third edition of the consolidated HIV guidelines in July 2021. This updated version will include the new service delivery guidance presented here.

In 2019, WHO and Coalition for Children Affected by AIDS convened a learning session of scientific and programmatic experts to consolidate the evidence on why HIV-affected adolescent mothers and their children are being left behind and to deliberate on the multiple-level changes needed to improve their outcomes. This technical brief follows on from that session and will be useful to HIV programme managers in health ministries and other adolescent- and youth-linked line ministries, especially those in in sub-Saharan Africa, in implementing, monitoring and evaluating adolescent and youth-responsive and -friendly health services for young mothers living with HIV. This technical brief aims to inform and support global dialogue and accelerate action on prioritizing services and support for adolescent and young mothers living with HIV. It details core programmatic examples and key strategies actions from across sub Saharan Africa that demonstrate how governments, health facilities, social services, communities, families and adolescent and young mothers are working together to bridge the gap between adolescent and adult-focused HIV and maternal health services. The programme examples provided serve to highlight potential and ongoing learnings in countries.

This book provides an overview of the current epidemiology of the HIV epidemic among young people in Eastern and Southern Africa (ESA) and examines the efforts to confront and reduce the high level of new HIV infections amongst young people. Taking a multi-dimensional approach to prevention, the contributors discuss the many challenges facing these efforts, in view of the slow progress in curbing the incidence of HIV amongst young people, focusing particularly on the structural and social drivers of HIV. Through an examination of these issues, chapters in this book provide valuable insights on how to mitigate HIV risk among young people and what can be regarded as the catalysts to mounting credible policy and programmatic responses required to achieve epidemic control in the region. The contributors draw on examples from a range of primary and secondary data sources to illustrate promising practices and challenges in HIV prevention, demonstrating links between conceptual approaches to prevention and lessons learnt from implementation projects in the region. Bringing together social scientists and public health experts who are actively engaged in finding effective solutions, the book discusses ‘which interventions works’, ‘why they work’, and the limitations and gaps in our knowledge to curb the pandemic amongst young people. As such it is an important read for researchers focusing on HIV/AIDS and public health. The Open Access version of this book, available at https://www.taylorfrancis.com/books/e/10.4324/9780429462818 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.