First decade – PMTCT and paediatric AIDS

Second decade – Preventing HIV infection among adolescents

Across both decades – Protection and care for children affected by AIDS

Policy briefs


Second decade – Preventing HIV infection among adolescents

© UNICEF/NYHQ2009-1352/Bonn
Young people of a community gather to discuss HIV/AIDS in Rwanda.

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[1] 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/NYHQ2007-1738/Nesbitt
An adolescent girl and boy perform a play on HIV/AIDS awareness and prevention for fellow students in Angola.

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

  • In Lesotho, HIV prevalence among 15-17 years old girls declined from 6 per cent  in 2004 to 3 per cent per cent  in 2009, while in Malawi, HIV prevalence among young women 23-24 years of age declined from 16.8 per cent  in 2004 to 7.5 per cent  in 2010. In both countries HIV testing and counseling was the behavior that contributed to the most impressive changes.

  • In South Africa, about 2000 adolescents belong to Girls and Boys Education Movement clubs in schools, where they receive life skills and information on AIDS, gender-based violence, teenage pregnancy and other issues. 

  • In Kenya, a life skills curriculum for use in primary and secondary schools has been finalized and is now being implemented.

  • In Namibia, the HIV-prevention focussed life skills programme My Future is My Choice has been made mandatory for all Grade 8 learners.

  • In Tanzania, a national life skills education framework was approved in 2011 and a draft HIV-sensitive life skills package was piloted in three districts in 2012. UNICEF is also supporting the Tanzania Commission for AIDS to create a programme for teenage girls who are in and out of school to reduce HIV, unwanted pregnancies and gender-based violence in selected districts.

  • In Botswana, an adolescent care package was developed in 2011 and included HIV counselling and treatment, sexual and reproductive health, nutrition and HIV prevention. 

  • Zimbabwe has developed an Adolescent Sexual Reproductive Health, HIV and AIDS Strategic Plan (2011–2015) and established a HIV/AIDS and Life Skills Secretariat.


[1] Comprehensive knowledge is a combination of 5 indicators including 2 on modes of transmission and 3 misconceptions.



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