Implementation guidance for health providers and planners

Adolescent-friendly services

Adolescent-friendly services are accessible, acceptable, appropriate, effective and equitable. Providers of these services are sensitive to their young clients' needs, they encourage autonomy and demonstrate respectful and non-judgmental attitudes. They know of the importance adolescents give to privacy and confidentiality.

Adolescents living with HIV want and need to feel 'normal' and to feel that they fit in with their peers. They also need honest, up-to-date information about HIV so that they can fully understand their condition, why they are on ART and how important it is to adhere to their treatment. Adolescents also need to know that they can live a full life and how they can do this, especially with regard to sex and relationships.

In all settings where ART clinics are situated, health planners and providers need to make efforts to reduce barriers to and challenges within services to support delivery of quality HIV care that is acceptable to adolescents, and encourages and supports them to make a commitment to their own health and understand their responsibilities. The development of policies and protocols that support the provision of services including access to HIV testing and counselling, ART and reproductive health can assist in addressing these barriers and challenges. The most important issues in this regard are consent, transition from paediatric to adult care, and strategies to address retention in care.

In resource-constrained settings, establishing adolescent- and youth-friendly services can be challenging. With careful assessment of needs and resources, there are ways to undertake simple low-cost adaptations to services that can increase the appeal of services to younger client groups. Additionally, through linkages and collaborative relationships with other community-based services and programmes, gaps can be addressed to help provide a comprehensive approach to adolescents' care. Health care planners and providers need to determine how best to adapt services to be more adolescent- and youth-friendly in their own settings.