HIV is a daunting public health problem for adolescents worldwide. An estimated 2.4 million adolescents (10-19 years old) are living with HIV, and new infections are increasing in many countries. Adolescents generally have poorer HIV outcomes compared to adults, leading to increased death and disability. The HIV epidemic is changing right before our eyes, with more HIV infections forecasted to occur outside the regions we have long considered to be the epicenter of the epidemic. These trends have accelerated strategic dialogues to inform the next global HIV strategy.
In response, a youth-led research team organized a systematic review and open call to identify HIV interventions for adolescents in high-burden countries. The team organized a systematic search for interventions to improve HIV and related outcomes among adolescents aged 10-19 in high-burden HIV countries in articles published between January 1, 2015, and September 27, 2024. This systematic review was part of a larger, collaborative UNICEF/WHO/UNAIDS Blueprint to inform adolescent HIV strategy. UNC collaborators played a significant role in this systematic review. Four young people from UNC shared first authorship of the study, including one undergraduate student, one graduate student, and two research assistants at UNC Project-China.
Key Themes
Youth engagement emerged as a key theme in the research. This refers to young people working in partnership with researchers to develop, implement, and evaluate. Co-first author Dorian Ho, a UNC undergraduate, noted, “Youth in high-burden settings know the impact of HIV – whether from being born with the virus, being orphaned as a child, or seeing it harm their classmates and communities. Therefore, it only makes sense that youth have a voice in shaping research and policy.” The systematic review found that youth engagement in HIV research was feasible but not universal in many high-burden HIV settings. The review also found that higher youth engagement is associated with greater HIV testing.
Another promising intervention that emerged from the review is differentiated service delivery, a client-centered approach that aims to simplify and adapt HIV services. Studies using differentiated service delivery improved viral suppression and ART uptake among adolescents.
Join the Open Call
Alongside these promising findings, several members of this team launched an open call focusing on co-creation for youth. Learn more about the open call.
Read the systematic review published in eClinical Medicine.
Submitted by UNC Project-China