Implementation guidance for health providers and planners

Increasing access to services

For many reasons, adolescents are less likely than adults to be tested for HIV and less likely to be linked to services, whether they test positive or negative. Under-utilization of testing and counselling services results in late diagnosis and missed opportunities to initiate treatment, counselling, care and other supportive services. Unfortunately in many countries, legal barriers requiring a parent or caregiver's consent to HIV testing can complicate access to testing and treatment for this age group, often discouraging adolescents from seeking the services they need. Increasing uptake of HIV testing and counselling could lead to earlier diagnosis, more effective care and more opportunities to prevent onward HIV transmission.

Adolescents are the only group that have not seen decreases in HIV-related mortality in recent years. More perinatally-infected children are surviving into adolescence, and HIV acquisition among adolescents currently results in over a third of new HIV infections every day. Health providers and planners need to reassess what can be done to help adolescents – particularly those who have been on treatment as children – make the transition to adult services. All adolescents should be encouraged to take full advantage of HIV testing and counselling services, to start treatment as soon as they need it, and to adopt better health-seeking and self-management practices. When this occurs, more adolescents are able to lead healthier, happier and more productive lives both now and into the future.

Antiretroviral therapy (ART) is now available in many settings, and there are a broad range of proven approaches to HIV prevention. This makes the task of expanding HIV-related services for adolescents more feasible than ever before. Health providers and planners know how to expand services, promote early diagnosis, reduce transmission, provide many types of support and improve health outcomes - but services that cater specifically to adolescents and their particular needs have not been widely developed.