|Year : 2013 | Volume
| Issue : 4 | Page : 223-224
Adolescents and HIV: This is time to prioritize
Praveen Kulkarni1, Prashant Vishwanath2
1 Department of Community Medicine, JSS Medical College, SS Nagar, Mysore, Karnataka, India
2 Department of Biochemistry, JSS Medical College, SS Nagar, Mysore, Karnataka, India
|Date of Web Publication||7-Feb-2014|
Department of Community Medicine, JSS Medical College, SS Nagar, Mysore, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kulkarni P, Vishwanath P. Adolescents and HIV: This is time to prioritize. Int J Health Allied Sci 2013;2:223-4
Adolescence (10-19 years) is a phase of life which has recently gained recognition as a distinct phase of life with its own special needs. This phase is characterized by acceleration of physical growth and psychological and behavioral changes, thus bringing about transformation from childhood to adulthood. Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults. Due to changing demographic trends India is a country with largest number of adolescents and young people in the world. It is estimated that 243 million adolescents reside in the country which constitutes 20% of global adolescent population. 
HIV continues to be a major global public health issue, having claimed more than 36 million lives so far. There were approximately 35.3 (32.2-38.8) million people living with human immunodeficiency virus (HIV) in 2012. Sub-Saharan Africa is the most affected region, with nearly 1 in every 20 adults living with HIV. Sixty-nine percent of all people living with HIV are living in this region. In 2012, more than 9.7 million people living with HIV were receiving antiretroviral therapy (ART) in low- and middle-income countries.  According to the HIV Estimations 2012, the estimated number of people living with HIV/AIDS in India was 20.89 lakh in 2011. The adult (15-49 years age group) HIV prevalence at national level has continued its steady decline from estimated level of 0.41% in 2001 to 0.27% in 2011. But still, India is estimated to have the third highest number of estimated people living with HIV/acquired immunodeficiency syndrome (AIDS), after South Africa and Nigeria. 
India is arguably a home for largest number of orphans and vulnerable children living with HIV. It is estimated that 13% of them acquire HIV infection through sexual contact and 20-30% of female sex workers in the country are less than 18 years. However, there is no accurate statistics available on the prevalence of HIV/AIDS among these age groups due to relatively lesser attention given to them by policy makers and program managers. 
Adolescents are at higher risk of acquiring HIV/AIDS because this is a phase of experimentation and risk that includes early sexual debut, sexual coercion and violence, trafficking, and substance abuse. Along with these, other factors such as the lack of knowledge about HIV/AIDS, inaccessibility to healthcare services and commodities, lack of education and life skills, and early marriage have increased their vulnerability to HIV/AIDS. Since adolescents comprise a major part of reproductive group, they are likely to play a significant role in determining the future growth pattern of India's population and economy. Thus, it is crucial that investment in terms of finances, research, and developmental policies be done to improve their well-being.  Targeting this population will lead to better utilization of funds and motivation of this group can incite a chain reaction carrying the message across all age groups.
There are multitude of challenges related to prevention, control, and treatment of HIV/AIDS among adolescents which are complex to handle. As adolescents with infection survive for a longer duration, they need a chronic, lifelong care, and support. Apart from coping with illness/lifelong treatment and adherence, there are also issues related to disclosure, education, and developing relationships.  There is always a serious threat related to social stigma and discrimination which has a definite impact on their psychosocial development and well-being. Being not able to adjust themselves with the mainstream of the society and their peers, poor or lack of familial support due to early orphanage (majority of the adolescents with HIV are born to HIV positive parents) suffer from serious consequences.
Prevention of HIV infection among adolescents is the only effective solution at the current scenario. This also has serious challenges like poor behavior change communication strategies available for providing knowledge about HIV, uncontrolled child trafficking, childhood prostitution, child labor, sexual abuse of children, higher gender inequalities, and larger media influences on sex and sexuality. Biggest among all these is parent to child transmission of HIV where adolescents unfortunately suffer from the consequence of the mistake in which they are not directly involved.
These challenges can be effectively addressed by some of the strategies like, early school-based education programs on causes and consequences of HIV/AIDS, including education on sex and sexuality in the school syllabus and effectively communicating the same to children through trained teachers, reinforcing the knowledge related to HIV/AIDS through special programs like HIV awareness lectures, group discussion, counseling sessions, documentary video films, etc., Efficient utilization of mass media plays acts as a most important strategy in spreading HIV awareness among youth. Recent inclusions in this can be using social networking sites like facebook, Google, WhatsApp, WeChat, etc., for increasing the knowledge related to HIV. Implementation of stringent laws against various social evils like child trafficking, child labor, prostitution, sexual abuse of children, and strict surveillance of them should be given highest priority.
There is a need for better political and administrative commitment, establishing good public private partnership through involvement of nongovernmental organizations, adolescent HIV infection should be declared as a priority area under National AIDS Control Program-IV, bringing a separate adolescent HIV/AIDS prevention and control policy in the country addressing the key issues mentioned above. Integration of HIV/AIDS prevention activities with regular school health program and to design, strategies for addressing non-school going adolescents, adolescent female sex workers, adolescent males having sex with males, and injectable drug users are required for better control and decline in incidences. Utmost importance should be given for the parent to child transmission of HIV through strengthening Prevention of Parent to Child Transmission (PPTCT) centers.
Adolescent HIV infection has remained as a serious untouched area that needs to be prioritized. Considering the seriousness of the situation, World Health Organization has declared adolescent HIV as the thrust area for the World AIDS Day-2013. There are similar efforts needed from national governments and nongovernmental agencies for the prevention and control of this life taking scourge. YES! THIS IS THE TIME TO PRIORITIZE!!!
| References|| |
|1.||Mothi SN, Swamy VH, Lala MM, Karpagam S, Gangakhedkar RR. Adolescents living with HIV in India-The clock is ticking. Indian J Pediatr 2012;79:1642-7. |
|2.||UPL. Available from: http://www.who.int/mediacentre/factsheets/fs360/en/index.html [Last downloaded on 2013 Nov 22]. |
|3.||Annual Report-2012-13, NACO, Department of AIDS control, Ministry of Health and Family Welfare, Government of India. Available from: http://naco.gov.in/upload/Publication/Annual%20Report/NACO_AR_Eng%202011-12.pdf [Last downloaded on 2013 Nov 23]. |
|4.||Kurapati S, Vajpayee M, Raina M, Vishnubhatla S. Adolescents living with HIV: An indian profile. AIDS Res Treat 2012;2012:576149. |