Workshop Highlights From Week 1 | HIV & Adolescence 2020

The International Workshop on HIV & Adolescence 2020 is taking place as a series of virtual sessions during the month of November with the aim to share experiences, knowledge, and best practices on optimizing the care of adolescents living with HIV across the spectrum of health and developmental needs.

The multidisciplinary summit kicked off last week with an opening session, two thematic sessions, and a skills building workshop. Each week during the HIV and adolescence month, the Children and AIDS Learning Collaborative will provide highlights from the workshop in partnership between UNICEF and Virology Education.

Continue reading below for a summary of the first week's sessions.
 

Keynote speaker Tumie Komanyane from Frontline AIDS set the stage for the session by sharing the story of her journey from adolescent peer to practitioner. 

Three oral abstracts were presented on adolescent sexual and reproductive health. Mercy Marimirofa from Zimbabwe National Family Planning Council shared findings from a knowledge, attitudes, and practices study on contraceptive use among university students in Zimbabwe. Dr. Samukelisiwe Nyamathe from Hope Cape Town examined the risk of HIV infection in young peripartum women. The final abstract was presented by Dr. Carmen Logie from the University of Toronto, who shared contextual considerations to guide optimization of the HIV prevention cascade for urban refugees and displaced adolescents and youth in Kampala, Uganda.

The findings presented revealed that large gaps continue to exist between levels of sexual activity and contraceptive use. Accessibility, affordability, social norms and religion pose as obstacles to using family planning services among young people attending tertiary education. As high levels of correct knowledge and awareness do not always translate into uptake of contraceptives, there is a need to motivate young people and facilitate referrals. A risk assessment tool found that more than half of young women giving birth at Tygerberg Hospital, South Africa, were found to be at high risk of HIV infection within the next year. The tool can be used to invest in HIV protective factors and address key risk factors in this population.

There is a scarcity of youth-focused HIV prevention programmes in humanitarian contexts. The study from Kampala showed that the convergence of intersectional stigma (related to age, refugee status, sex work, and HIV), inequitable gender norms, prevailing socio-cultural norms, and economic insecurity posed as significant barriers to engaging young refugees in the HIV prevention cascade. The authors stressed the need to address norms and offer contextualised, trauma-informed care to reach and improve HIV outcomes among urban refugee youth.
 
The speakers concluded that we must look at adolescent issues holistically. Effective approaches can be found in peer support programmes and adolescent clubs as well as initiatives that capacitate youth leadership and agency. When implementing programmes, managers must adopt modern digital solutions that speak to the adolescents of today.
 

This interactive session featured keynote speaker Dr. Edgar Lungu from UNICEF Zambia, who shared information on access and barriers to HIV testing and evidence-based approaches that have been used by different country programmes to increase the low rates of HIV testing among adolescents. Three abstracts were presented, which emphasized some of these interventions. 

• Dr. Mwate Chaila from Catholic Relief Services Zambia shared findings from the HPTN071 (PopART for Youth) study, which offers a community-based combination prevention package to adolescents and young people aged 10-24 years. A validated screening tool used by providers to identify adolescents at risk of HIV increased the yield of HIV positive tests (2.4% in 'at risk' group versus 0.6% in the 'not at risk' group) and can effectively be used to target testing to maximize efficiency gains in resource-limited settings. This presentation was complemented by Fungai Mudzengerere from FHI360 who shared HIV testing uptake and ART initiation rates among adolescent girls and young women enrolled in the DREAMS programme in Zimbabwe.

• Wylene Saal, University of Cape Town, presented a study that explored the association between disclosure of HIV status and experiences of stigma among adolescents living with HIV in South Africa. These experiences may overlap with HIV risk and infection and must thus be considered when designing psycho-social support interventions for adolescents.

The session highlighted multiple barriers to HIV testing among adolescents, including limited knowledge of HIV prevention, age of consent, poor access to quality adolescent friendly services, and a lack of adolescent focused data to inform programmes. HIV testing approaches that have been proven to improve access among adolescents include index testing, self-testing, and community-based testing modalities.

The panel recommended applying a mix of diverse service delivery approaches to balance efficiency and impact. The panel further recommended conducting targeted community campaigns to reach different groups of adolescents, for example boys through football. HIV testing can be optimized for adolescents through engagement of the available community structures, social networks, and adolescent peer networks. However, community-based referral approaches should develop strategies to shorten delays from community referral to linkage to HIV treatment and care. For those testing positive, support systems should also be facilitated for adolescents to disclose their HIV status.  
 

Parallel skills building sessions took place on abstract writing and participatory research methods, demand generation, tools to engage adolescents and young people, and the use of data to improve HIV and sexual and reproductive health outcomes for adolescents.

Lively discussions took place in the data workshop on understanding challenges related to adolescent HIV knowledge, pregnancy, testing, contraception, and living with HIV through disaggregated data. Below screenshot testifies to individual commitments made by participants to become data champions for adolescent health.  
 

The Children and AIDS Learning Collaborative connects stakeholders around the world on HIV and AIDS topics related to children, adolescents and pregnant women. Led by UNICEF, the community shares the latest research, publications, webinars and learning activities through email updates and on www.childrenandaids.org.