Journal
CURRENT OPINION IN HIV AND AIDS
Volume 13, Issue 3, Pages 257-264Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/COH.0000000000000452
Keywords
adolescents; barriers; HIV; strategies; testing
Categories
Funding
- Wellcome Trust [206316/Z/17/Z]
- MRC/DFID [MR/P011268/1]
- MRC [MR/P011268/1] Funding Source: UKRI
- Medical Research Council [MR/K012126/1, MR/P011268/1] Funding Source: researchfish
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Purpose of reviewHIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared with adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa.Recent findingsThere are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle. There has been progress made in recent years in developing strategies that address some of these barriers, increase uptake of HTC and yield of HIV. These include targeted approaches focused on provision of HTC among those higher risk of being infected, for example, index-linked HTC and use of screening tools to identify those at risk of HIV. Community-based HIV-testing approaches including HIV self-testing and incentives have also been shown to increase uptake of HTC.SummaryIn implementing HTC strategies, consideration must be given to scalability and cost-effectiveness. HTC approaches must be coupled with linkage to appropriate care and prevention services.
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