Second decade - Preventing HIV infection among adolescents
In 2011, there were an estimated 1.2 million adolescents 10-19 years old living with HIV in Eastern and southern African, more than half of all HIV-positive adolescents globally.
During the past 10 years, with intensified investments in prevention and treatment, HIV prevalence among young men and young women showed a decline in almost all countries in the region, especially in Botswana, Ethiopia, Malawi, South Africa, Tanzania and Zimbabwe. Some of the reduction came as a result of safer behaviour patterns, including increased uptake of HIV testing and counseling, delay of first sex, reduction in the number of partners, and increased condom use.
The percentages of adolescents living with HIV vary widely across the region, but the risk of becoming infected is disproportionately higher for young women than for young men in every country except in Madagascar. Girls’ disproportionate vulnerability to HIV infection stems from both greater physiological susceptibility to heterosexual transmission, and from social and economic disadvantages and gender inequality they confront. Among young women, estimated prevalence in 2011 was as high as 12–15 per cent in Lesotho, South Africa and Swaziland.
Even though HIV prevalence has been declining among adolescents in most of the region, knowledge of AIDS is still surprisingly low. On average, among the 15-19 years old, only about 39 per cent of males and 34 per cent of females demonstrated comprehensive knowledge of AIDS, with only two countries exceeding 50 per cent: Namibia and Swaziland.
UNICEF in action
In order to achieve better results for adolescents in the second decade, UNICEF programming has shifted away from a broad emphasis on “young people” to a more targeted focus on adolescents (10-19 years). To this end, UNICEF, working jointly with UNFPA, WHO and UNESCO, supports countries to strengthen comprehensive approaches to HIV prevention, treatment, and care and integrated service delivery for adolescents.
A mix of interventions are being strengthened to lower the risk of HIV transmission among adolescents. These include utilization of HIV testing and counselling, the use of male and female condoms, voluntary medical male circumcision, prevention of mother-to-child transmission - from HIV-positive adolescent mothers to their children, and increased access and early initiation on antiretroviral treatment.
UNICEF also advocates for more focused investments to address inequalities and tackle conditions that exacerbate adolescent vulnerability to HIV, such as risky behaviours linked with gender violence and poverty. Working jointly with sectors such as child protection, social protection, and education will be critical for implementing such a strategy.
By encouraging and supporting active involvement and leadership of adolescents, including those living with HIV, we can ensure that HIV prevention, treatment and care programmes among adolescents are adolescent-specific and better tailored to their needs.
Results for children
 Comprehensive knowledge is a combination of 5 indicators including 2 on modes of transmission and 3 misconceptions.
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