Young people with HIV in North America and Europe now have near-normal life expectancy. New diagnoses of HIV have fallen among men who have sex with men in England. These recent findings are incredibly positive and should be celebrated. Progress is being made, but HIV/AIDS is far from over, especially in low-and middle-income countries, and particularly in sub-Saharan Africa.
The largest ever generation of adolescents in sub-Saharan Africa is at risk of HIV, many of these young people are failing to test for the virus and access the relevant follow-up care and treatment… and the world is not listening to them. Inevitably, new infection and death rates are rising in the region. Globally the number of adolescent deaths from AIDS tripled in 15 years and HIV is a leading cause of adolescent deaths in Africa. Women and girls are most at risk - around 7,500 young women become newly infected with HIV every week in sub-Saharan Africa.
It is clear that adolescents and young people in this part of the world are being left behind in the HIV/AIDS response. Worse still, their views and needs are being overlooked - a stark reality that was brought home to us and global leaders in HIV/AIDS during a recent roundtable discussion organised by Sentebale, their Co-Founding Patron, Prince Harry, and the London School of Hygiene & Tropical Medicine.
We were privileged to welcome three of Sentebale’s youth advocates – young people living with HIV from Lesotho and Botswana - countries with the second and third highest infection rates of HIV in the world. Hearing their experiences first-hand was a powerful testimony to the challenges facing young people affected by HIV in southern Africa.
We heard about the negative impact of a limited and poor education, and how youth-friendly health services are anything but. We learnt how the stigma surrounding HIV/AIDS - still ingrained in the region’s facilities, schools and communities - makes young people think twice about visiting a testing clinic because of the attitudes of health professionals or, as the age of consent is often 16, the thought of having to ask their parents or guardians for permission - no easy task for any teenager.
Pressure on young shoulders is immense, and this brings its own problems. The intersection between mental health issues and HIV can prevent people from receiving treatment and stop them taking it. This is just one area that must be further explored and addressed.
We simply don’t yet know how best to tackle many of these problems. The youth advocates’ insights not only reinforce the importance of the School and Sentebale’s important HIV/AIDS adolescent research and programmes in southern Africa, but also crucially pave the way for new research avenues. By producing and using the most rigorous scientific evidence, more effective interventions can be shaped and implemented on the ground.
Ultimately, the global community desperately needs to understand and learn from young people affected by HIV. We hope our roundtable discussion will spark new dialogue and research. At the event, global HIV leaders committed to moving young people higher up the agenda and to ensuring their voices are heard. This is a positive step but must be a catalyst for change. The 2018 International AIDS conference in Amsterdam is a key opportunity to keep the momentum going as young people will be a focus at the event.
If we are to reduce stigma, breakdown barriers to treatment and care, and provide services that are tailored to the reality of being a young person living with or at risk of HIV, young people need to play an integral part in research and policymaking. Bringing the AIDS epidemic to an end requires the global health community to work together and listen to those directly affected.
Last year Prince Harry called for the world to step-up its support for young people affected by HIV/AIDS. Empowering them, to ensure that their voices are heard and acted upon, is crucial if we are to make the great strides that are necessary. Young people – whatever their HIV status – deserve the chance to lead healthy, happy and productive lives.