Adolescent HIV prevention

HIV in adolescents

In 2021, about 1.71 million [1.24 million–2.21 million] adolescents between the ages of 10 and 19 were living with HIV worldwide. Adolescents account for about 5 per cent of all people living with HIV and about 11 per cent of new adult HIV infections. About 1.47 million [1.06 million–1.87 million] (86 per cent) live in sub-Saharan Africa. Outside of sub-Saharan Africa, the highest numbers of HIV-positive adolescents are in Asia and Latin America.

Globally, in 2021, adolescent girls accounted for three quarters of all new HIV infections among adolescents. Among the 35 HIV priority countries in UNICEF’s Strategic Plan, this proportion was even higher with adolescent girls accounting for four fifths of all new HIV infections among adolescents. In sub-Saharan Africa that year, almost six times as many adolescent girls were newly infected with HIV than adolescent boys. In East Asia and the Pacific, more boys are newly infected with HIV each year than girls in adolescence. This reflects differences in risk behaviour in these regions, which means that interventions must be tailored to the specific nature and dynamic of the epidemic.

In some sub-Saharan countries, adolescent girls are two to three times more likely to be infected with HIV than boys of the same age group. However, HIV does not only affect sub-Saharan Africa, and in 2021, 26 per cent of adolescents newly infected with HIV lived outside of the region.

Interventions for HIV prevention among adolescents

According to UNAIDS estimates, HIV incidence has fallen in many of the most severely affected countries because adolescents and young people are adopting safer sexual practices and more young people living with HIV are accessing treatment to lower their viral load. However, in regions with available data, recent testing coverage remains below 25 per cent for adolescents. This means many adolescents and young people living with HIV may not know their status. Furthermore, boys are consistently less likely to have been tested for HIV compared to girls.

In countries with generalized epidemics, schools can be a critical venue for reaching adolescents with the information and skills they need to avoid HIV infection. Evidence shows that school-based sex education can be effective in changing the knowledge, attitudes and practices that lead to risky sexual behaviour.

Preventing HIV in countries with low prevalence or where the epidemic is concentrated in specific populations is especially challenging since the spread of the virus is fuelled by high-risk, often stigmatized behaviour. People who engage in such behaviour tend to be young and include sex workers, people who inject drugs and men who have sex with men.

No matter the epidemic, it is imperative that adolescents possess comprehensive and correct knowledge of HIV prevention to protect themselves from infection. However, rates of comprehensive knowledge remain below 50 per cent in most countries with available data. In addition, girls and boys may have disparate levels of HIV knowledge depending on the country context.

For information on UNICEF’s programme and policy work, visit the Children & AIDS community of practice.