New focus on adolescents

TODAY is World AIDS Day 2013. The usual outpouring of dreary and mundane messages today from the HIV and AIDS czars worldwide has become the in-thing. Since yesterday, this lacklustre and humdrum surge of World AIDS Day 2013 messages began to hit the airwaves and the print media.World AIDS Day is a day when all the emperors of HIV and AIDS show their wares, to justify their means of livelihood. And when the day ceases to be December 1, the return to the grind and making routine pedestrian responses to HIV and AIDS become commonplace for another year.
A lot has not changed since 2001, when UNESCO’s Gudmund Hermes noted thusly: “The virus was ahead of the disease, the disease was ahead of the response, the response was a disaster, and management of the disaster was underfunded.”

‘A lot has not changed since 2001, when UNESCO’s Gudmund Hermes noted thusly: “The virus was ahead of the disease, the disease was ahead of the response, the response was a disaster, and management of the disaster was underfunded’

Today, we can shout out on the rooftops that we have more funding to combat this chronic disease. But skill incapacity and bureaucratic constraints guarantee that the response remains sluggish.
In 2011 and 2012, the World Health Organization (WHO) conducted several surveys, and found that adolescents in many countries did not have adequate access to HIV testing, counselling, and treatment. Between 2005 and 2012, there was a 30% reduction globally in HIV-related deaths. However, in the same time period, HIV-related deaths among adolescents rose to 50%.
As a response to this sordid state of affairs among adolescents and happening for the first time, the WHO in November 2013 released guidelines on “HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV”. These guidelines are urging governments to assess their policies on consent to services to facilitate adolescents to have HIV testing without parental consent; and to upgrade the quality of care and social support for adolescents living with HIV (ALWH).

‘If we are to preserve a healthy and productive labour force for the future, World AIDS Day 2013 requires all governments and interested stakeholders to vigilantly focus on adolescents, in order to rapidly accept and implement the new WHO guidelines on adolescents’

These WHO guidelines on adolescents have come out at a time when the University of the West Indies Press has recently published my book manuscript, HIV & AIDS Knowledge and Stigma in Guyana, with a focus on adolescents (high school students).
This book arose out of my concerns over the probability of an increasing trend in high-risk sexual behaviours among adolescents in Guyana. These concerns relate to the perception that many adults in Guyana and elsewhere were graduating from HIV to an AIDS status in their twenties. Therefore, it was possible to conclude that many persons with HIV in Guyana and elsewhere contracted the HIV infection in their adolescence.
Undoubtedly, school-based HIV prevention intervention programmes are critical in HIV prevention in Guyana. With about half of Guyana’s population under age 24 (50.9%), and about 70% under age 14 (Population and Housing Census 2002), schools would have an in-built infrastructure with extensive reach during a crucial developmental period in adolescence (Yazdi et al. 2006).
Adolescents also are appropriate targets for school-based interventions because their attitudes and behaviours are still being developed (NIH 1997; UNAIDS/WHO 2004). In addition, interventions have a higher success rate when introduced before adolescents begin experimentation with risk behaviors (Grunseit 1997).
There could hardly be any dispute about the damage HIV and AIDS are inflicting on the global sector over the last three decades. Indeed, the harm from HIV and AIDS remains phenomenal for poor countries where entire economies experience devastation.
If we are to preserve a healthy and productive labour force for the future, World AIDS Day 2013 requires all governments and interested stakeholders to vigilantly focus on adolescents, in order to rapidly accept and implement the new WHO guidelines on adolescents.
And governments have a moral obligation to remove the monstrosity of bureaucratic constraints and skill incapacity, thus constructing a new environment to fight HIV and AIDS. Let this World AIDS Day 2013 be the threshold for the new active focus on adolescents in this enduring battle against HIV and AIDS.

(By Dr. Prem Misir)