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Review of Policies Guiding the Adolescent HIV Care Continuum in 16 sub-Saharan African Review of Policies Guiding the Adolescent HIV Care Continuum in 16 sub-Saharan African

Review of Policies Guiding the Adolescent HIV Care Continuum in 16 sub-Saharan African - PowerPoint Presentation

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Review of Policies Guiding the Adolescent HIV Care Continuum in 16 sub-Saharan African - PPT Presentation

Review of Policies Guiding the Adolescent HIV Care Continuum in 16 subSaharan African Countries Jepkoech Kottutt 1 Emilia D Rivadeneira 2 Susan Hrapcak 2 1 Hubert Department of Global Health Rollins School of Public Health Emory University Atlanta GA ID: 766422

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Review of Policies Guiding the Adolescent HIV Care Continuum in 16 sub-Saharan African Countries Jepkoech Kottutt1, Emilia D. Rivadeneira2, Susan Hrapcak2 1Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA2Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA22nd International AIDS Conference (AIDS 2018)Amsterdam, Netherlands | 23-27 July 2018RAI Amsterdam Convention Centre Center for Global Health

Background AIDSinfo|UNAIDS (available online using http://aidsinfo.unaids.org/) UNAIDS DATA 2017 (available online using http://www.unaids.org/sites/default/files/media_asset/20170720_Data_book_2017_en.pdf)Image : Slogrove et al. JAIDS, 2017 20(Suppl 3), 21520. http://doi.org/10.7448/IAS.20.4.21520 Adolescence is a period of great growth and development.Globally, ~2.1 million adolescents 10-19 years were living with HIV with a majority of them living in sub-Saharan Africa 1 . AIDS-related deaths are steadily increasing among adolescents and it is the second highest cause of death within the sub-population globally. 2 AIDS-Related Deaths Among Adolescents

Background Kranzer K. et al. PLoS Med . 2014; 11:e1001649Phelps B. et al. AIDS. 2013;27(2):S207-213 Image: Created from data included in Brown K et al. MMWR, 2018;67:29–32. DOI: http:// dx.doi.org/10.15585/mmwr.mm6701a6 Healthcare workers face challenges in provision of services to ALHIV as many are not comfortable working with adolescents1,2.

Background Image: http://en.eecaac2018.org/world/who-guidelines-on-the-use-of-arv-drugs-for-treating-and-preventing-hiv-infection-second-edition/ Goal: This policy review assessed 16 PEPFAR-supported, sub-Saharan African countries for inclusion of policies and recommendations targeting adolescents within national HIV/ART and HIV testing guidelines. The 2016 WHO consolidated guidelines were the first that identified adolescents as a separate population. Countries have also recognized the need for adolescent-targeted policies and services.

Policy review of publicly available national HIV/ART and HIV testing guidelines in English. 5 thematic areas in which data were collected and assessed include:Frequency of HIV testing in sexually active adolescentsRecommended age of full disclosure Age of consent for treatment initiation Frequency of routine viral load (VL) in adolescentsRecommended age for transition from adolescent to adult servicesPolicies for adolescents living with HIV (ALHIV) along the HIV care continuum were abstracted, entered to a database and assessed.Analysis was performed using Microsoft Excel. Methods

Results *Kenya was the only country whose guidelines included all 5 thematic areas assessed. Inclusion of the Adolescent HIV Care Continuum in National HIV/ART Guidelines in 16 countries in sub-Saharan Africa Recommendation Countries Included% Frequency of routine viral load (VL) in adolescents Botswana, Cameroon, Kenya, Lesotho, Malawi, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe94%Frequency of HIV testing in sexually active adolescentsKenya, Lesotho, Rwanda , South Africa, Swaziland , Tanzania, Uganda, Zambia50% Disclosure Cameroon, Ethiopia, Kenya, Lesotho, Namibia, Rwanda, Tanzania, Zambia 50% Age for transition from adolescent to adult services Kenya, Namibia, Uganda, Zambia 25% Age of consent for treatment initiation Kenya, Rwanda, Swaziland 19%

Results: Knowing your HIV Status (1st 90) Frequency of HIV Testing in Sexually Active Adolescents Disclosure

Results: Treatment Initiation (2nd 90) Age of Consent for Treatment Initiation Transition from Adolescent to Adult Services

Results: Viral Suppression (3rd 90) Frequency of Routine VL in Adolescents

Limitations Limited to ART/HIV and HIV testing guidelines Did not include laws or policy amendments Did not include supplemental materials Limited to English-language guidelines

Conclusions

Acknowledgements Susan Hrapcak, MD Emilia D. Rivadeneira, MDPediatric and Adolescent HIV Team, Maternal and Child Health Branch, Division of Global HIV & TB

Thank you! For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348Visit: www.cdc.gov | Contact CDC at: 1-800-CDC-INFO or www.cdc.gov/infoThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Center for Global Health