New HIV guidelines vital this World AIDS Day

A major challenge is many young people do not know their HIV status. Inadequate support has resulted in a 50 per cent increase in AIDS-related deaths in this group compared to a 30 per cent decline in other groups from 2005 to 2012.

“Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults,” says Dr Gottfried Hirnschall, Director of WHO HIV/AIDS Department.

“Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”

The integration and linking of related services such as programmes for HIV, sexual and reproductive health, maternal and child health, and tuberculosis can help reduce missed opportunities for HIV testing and promote early antiretroviral therapy in teens and young adults.

Recent surveys in countries with generalized epidemics show that, in most of these countries, less than 50 per cent of young women and men have a basic understanding of HIV.

“Young people need to be better equipped to manage their HIV infection and take ownership of their health care,” says Dr Elizabeth Mason, Director of WHO Maternal, Newborn, Child and Adolescent Health Department.

“We have seen for example in Zimbabwe that, by developing adolescent friendly services, it is possible to achieve good treatment outcomes among adolescents. We urge others to be inspired by these examples.”

In September 2013, the Regional Committee for Africa examined the potential impact of additional approaches such as home-based testing, mobile outreach, special testing and campaigns in workplaces, schools and universities, and other safe venues for key high-risk populations. These activities can help missed opportunities and provide improved support for adolescents.

The overwhelming majority of new HIV infections are transmitted through sex. A basic understanding of HIV and how it spreads is fundamental to behaviour changes that promote safer sex or abstinence.

Yet levels of such knowledge among young people are appallingly low, especially in the worst affected region. In sub-Saharan Africa, only 28 per cent of young women and 36 per cent of young men have a comprehensive and correct knowledge of HIV. This is an increase of only three and five percentage points, respectively, in almost a decade.

Since the disease onslaught, many scientific advances have improved HIV testing, treatments and outcomes. Simpler, safer, once-daily, single-pill antiretroviral therapy regimens are now more affordable and widely available.

In June 2013, WHO created the “Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection”, to better serve the 9.7 million people taking these lifesaving drugs. It is estimated that implementing these guidelines could save three million lives by 2025, leading to a 39 per cent reduction in AIDS-related deaths.

The incidence of HIV is declining steadily in most regions but 2.5 million people are newly infected each year. Applying these new guidelines can prevent approximately 3.5 million or 36 per cent of new HIV infections in the same time period.

Without education and treatment, approximately one third of children born to women living with HIV will become infected with the virus in the womb, at birth or through breastfeeding. This risk can be greatly reduced by treating an expectant mother with the new 2013 HIV recommendations.

World AIDS Day is a great opportunity to increase HIV awareness but we need to translate awareness into outcomes throughout the year.  

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