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Dilemma of adolescents with HIV

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By HALIMA ABDALLAH Special Correspondent

Eighteen-year-old Nicolas Lokeri’s smile belies his dilemma: To abstain or not? For how long?

“Maybe after school,” he says.

Having sex is trickier: He has HIV/Aids but is hesitant to reveal his status, fearing stigma and discrimination.

Lokeri (not his real name) was born with HIV but only learnt about his status in 2009.

He is not alone. Seventeen-year-old Rita Arinaitwe (not her real name) is equally struggling.

“I do not have a boyfriend and I do not wish to get one soon,” says Arinaitwe, who once lost friends at school after going public about her status. “There are men who ask me to be their girlfriend and I say no because I know that I am HIV-positive and I know that I should not spread it.”

Globally, many children who were infected with HIV at birth are now adults. While living with a chronic infection was foreseen, preventing transmission to healthy partners as they become sexually active is another matter altogether.

The International Aids Candlelight Memorial Day 2014, to be celebrated on May 18 under the theme “Let’s Keep the Light on HIV,” is an opportunity to highlight the plight of adolescents who present fresh challenges to the global fight against HIV.

Life-prolonging drugs have enabled many children born with the virus to grow to puberty; the difficult part now is to prevent them from infecting their HIV-free counterparts as they begin to explore their sexuality.

World Health Organisation (WHO) statistics show that more than two million adolescents aged between 10 and 19 years are living with HIV, which most of them acquired from their mothers. Unicef estimates that about one-seventh of all new infections occur during adolescence.

“We shall be talking to adolescents who are in discordant relationships,” said Dr Alex Ario, the acting programme director, Aids Control Programme, at Uganda’s Ministry of Health. “We shall offer them risk mitigation skills such as use of condoms, testing and disclosure of status to partners.”

Lack comprehensive knowledge

A recent study on HIV and adolescents to be released by the ministry shows that there are 130,000 adolescents aged 15-19 living with HIV, 63 per cent of whom are sexually active.

Ministry officials say many of these adolescents lack comprehensive knowledge on HIV and engage in unprotected sex. Dr Ario said 11.4 per cent of the girls have had unprotected sex before 15.

In sub-Saharan Africa, it is estimated that only 10 per cent of young men and 15 per cent of young women (15-24 years) know their HIV status.

Unicef suggests that additional investments of $5.5 billion in 2014 in such high priority areas could bring down the burden by 2020. Aids-related deaths within that age group rose from 71,000 to 110,000 in 2012, according to Stocktaking Report on Children and Aids, which Unicef released in December.

“Young people need to be better equipped to manage their HIV infection and take ownership of their healthcare,” said Dr Elizabeth Mason, director of the Maternal, Newborn, Child and Adolescent Health Department at WHO.

She added: “We have seen, for example in Zimbabwe, that by developing adolescent-friendly services it is possible to achieve good treatment outcomes among adolescents.”

In order to reduce new HIV infections among children, countries around the world are encouraging prevention of mother-to-child transmission, where HIV-positive mothers are given anti-retrovirals to suppress the virus, hence preventing the transmission to newborns.