Overview

Adolescents (10–19 years) and young people (20–24 years) continue to be vulnerable, both socially and economically, to HIV infection despite efforts to date. This is particularly true for adolescents — especially girls — who live in settings with a generalized HIV epidemic or who are members of key populations at higher risk for HIV acquisition or transmission through sexual transmission and injecting drug use. In 2012, there were approximately 2.1 million adolescents living with HIV. About one-seventh of all new HIV infections occur during adolescence.

These guidelines provide specific recommendations and expert suggestions — for national policy-makers and programme managers and their partners and stakeholders— on prioritizing, planning and providing HIV testing, counselling, treatment and care services for adolescents.

Contents

• Acknowledgements
• Abbreviations and acronyms
• Funding
• Executive summary
• Part One. GUIDELINES
  • 1. OVERVIEW
    • 1.1 Background
    • 1.2 Objectives
    • 1.3 Target audience
    • 1.4 Development of guidelines
    • 1.5 Evidence assessment
    • 1.6 Strength of recommendations
  • 2. RECOMMENDATIONS AND RATIONALES
    • 2.1 HTC for adolescents
    • 2.2 Adolescents living with HIV: disclosure, adherence and retention
    • 2.3 General service delivery recommendations
• Part Two. OPERATIONAL CONSIDERATIONS
  • 1. GUIDING PRINCIPLES FOR IMPLEMENTATION
    • 1.1 Voluntary testing
    • 1.2 Heterogeneity of adolescents
    • 1.3 Meaningful involvement of adolescents
    • 1.4 HTC minimum standards: The 5 Cs
    • 1.5 Gender issues
    • 1.6 Human rights perspective
    • 1.7 Developmental appropriateness
    • 1.8 Supportive and conducive legal and policy environment
    • 1.9 Legal protection
  • 2. PROGRAMMATIC EXPERIENCE AND LESSONS LEARNED
    • 2.1 HTC
    • 2.2 Disclosure
    • 2.3 Community-based approaches
    • 2.4 Training
    • 2.5 Other important considerations
  • 3. ADAPTING THE GUIDELINES
  • 4. RESEARCH GAPS
• REFERENCES
• ANNEX 1 Key terms and definitions
• ANNEX 2 PICO questions and references
• ANNEX 3 Systematic review – HTC for adolescents
• ANNEX 4 Systematic review – ALHIV: Disclosure, adherence and retention in care
• ANNEX 5 GRADE notation and language
• ANNEX 6 GRADE evidence profiles
• ANNEX 7 Evidence summaries and findings
• ANNEX 8 Decision-making tables
• ANNEX 9 Review methods
• ANNEX 10 Values and preferences: HTC
• ANNEX 11 Values and preferences: treatment and care for ALHIV
• ANNEX 12 Adolescent HIV testing and counselling: a review of the literature
• ANNEX 13 Adolescent ARV service delivery: a review of the literature
• ANNEX 14 Lessons Learned: Strengthening Health Services and Outcomes for Adolescents Living With HIV
• ANNEX 15 Adolescent consent to testing: a review of current policies and issues in sub-Saharan Africa
• ANNEX 16 Implementation plan
• ANNEX 17 Expert meeting – participant list

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