Ending the HIV Epidemic: Programme Directions for Adolescents Dr Susan Kasedde Senior Advisor HIV & Adolescents UNICEF, NYHQ #EndAdolescentAIDS

Acknowledgements Craig McClure Chewe Luo Amaya Gillespie Natalie Amar Tom Fenn Pat Lim Ah Ken Pricilla Idele Tyler Porth Paul Nary Olena Sakovych Magdalene Mayer Abdelkader Bacha Wing-Sie Cheng Nonglak Boonyabuddhi Peter Gordon Donna Futterman David Ross Bruce Dick Rachel Baggaley Catherine Sozi Bill Kapogiannis The Way Home, Ukraine Zvandiri, Zimbabwe Volunteers for Children Development Foundation, Thailand Federation of Sexual and Gender Minorities and Young Key Affected Populations, Nepal

3 Unacceptable inequality: AIDS deaths rising among adolescents Source: UNAIDS 2012 HIV and AIDS estimates

4 HIV and AIDS Among Adolescents 1. One in five people are aged between 10 and million adolescents live with HIV, 1.7 million (82%) in Sub-Saharan Africa, girls account for 60% 3. In all other regions: HIV concentrated in key populations 4.Two thirds of all new HIV infections in 2012 were among adolescent girls 5. HIV is now the second leading cause of death among adolescents, 300 deaths every day

Programme Guidance on HIV Testing and Counseling and Care in Adolescents Guidance document Policy Brief Implementation Toolkit ?ua=1

Review of Evidence 1.Executive Summary: Opportunities for Action and Impact 2.Epidemiology of HIV and AIDS Among Adolescents 3.Systematic Review of Systematic Reviews 4.Impact and Cost of HIV/AIDS Investment Framework for Adolescents 5.What Programs Work for Adolescent Girls? 6.Young Key Populations in Asia Pacific 7.Lessons Learned: Scale-Up of Voluntary Medical Male Circumcision 8.Lessons Learned: Scale-up of Adolescent Contraceptive Services 9.Lessons Learned From HPV Vaccine Delivery Preventing Sexual Violence and HIV in Children 10.Commentary: Innovations in Programming Operational Research Priorities

Key Findings from Systematic Review

In their words …

4 1.Invest more and invest smarter in adolescents 2.Deliver what works and strengthen Data on adolescents 3.Empower and Engage adolescents 4.Accelerate our response The IDEA What Can We Do?

INVEST in Adolescents

Reduce Risk Reduce the likelihood of transmission Reduce mortality and morbidity Critical Enablers Basic Programme Activities o PMTCT o Condom promotion and distribution o Key populations o Treatment care and support to PLWH o Male Circumcision o Behavior Change programmes Social Protection, Education, Legal Reform, Gender Equality, Poverty Reduction, Gender-Based Violence, Health Systems (inc. STI treatment & blood safety), Community Systems, Employer Practices SYNERGIES WITH DEVELOPMENT SECTORS

Smarter investments can decrease new infections Generalized epidemic settings Source: Stover, J. et al., JAIDS. (66) Jul, 1, 2014 New HIV Infections

Estimated Resource Needs for Adolescents: Modeling Results Programs Enablers Sector Synergies 33% 25% 40% Source: Stover, J. et al., JAIDS. (66) Jul, 1, 2014

Tailored DELIVERY Informed by DATA

Data Informed Delivery Albania: Inclusion of adolescent key populations in M&E systems Bangladesh: National strategy for adolescent key populations informed by population size estimates Tanzania & Zambia: Generating data on HTC and treatment coverage for coverage for adolescents

A Tale of Two Epidemics New HIV Infections in Adolescents in 20 Countries with Highest Number of New HIV Infections, 2012

Sexual Violence Sexual violence and HIV: History of abuse increases risk of HIV infection Sexual abuse: 18% of girls and 7% of boys Surveys by Together for Girls partnerships show higher rates of abuse Institutions and authorities don’t always act in the interest of children

Adolescent Key Populations

EMPOWER & ENGAGE Adolescents

Advocacy Programme design Demand for services Implementation support Monitoring

ACCELERATE. Step Up the Pace!

Thank You!