Implementation guidance for health providers and planners

Physical well-being

Adolescents living with HIV need support to establish health maintenance routines that will help them to remain engaged in care and adhere to lifelong treatment, to enjoy safe and fulfilling sexual and reproductive lives, and to understand the role that healthy eating and living plays in helping their bodies cope with the effects of HIV as well as medicines.

HIV care: Adherence to treatment, sexual and reproductive health and retention in care. For adolescents living with HIV, maintaining physical health requires adherence to treatment and continual engagement in care, as well as addressing sexual and reproductive health needs. All three of these areas are of vital importance to well-being, survival and the prospect of a healthy and full life. Adherence to treatment, retention in care and sexual and reproductive health are covered in dedicated sections of this tool.

Nutrition. Many adolescents neglect healthy eating by consuming too much high calorie food and/or skipping meals, and many have erratic eating patterns due to busy lives. Vulnerable adolescents such as orphans, those living in child-headed households or on the streets, and others, often face food insecurity. Adolescents taking ART may experience loss of appetite due to the side-effects of some antiretrovirals.

Eating a nutritionally balanced diet – as well as being attentive to other aspects of daily living such as exercise, adequate sleep and limiting alcohol and tobacco use – can help to maintain a healthy immune system as well as helping ARVs to work more effectively in the body. Management of many HIV-related symptoms – such as diarrhoea, nausea, vomiting, mouth and throat sores, and loss of appetite – can be supported with food-based interventions (in combination with ART). When a person's immune system is strong, their medicines are working and symptoms and side-effects of treatment are being managed, they feel better and more able to live a normal life.

Health care providers should support nutritional care as a component of routine HIV care and positive living by:

  • advising adolescents on eating a well-balanced diet;
  • monitoring nutritional and health status by weighing their adolescent clients at each visit, comparing their weight to age norms (weight/body mass index for age), recording their weight in the patient chart, and looking for and asking about changes;
  • referring adolescents who do not eat enough due to a lack of food or insufficient funds to appropriate social services and food assistance programmes.