This story was originally published by UNICEF

In Mozambique there has been some progress in the fight against AIDS, notably in preventing mother to child transmission of HIV. But progress in preventing new HIV infections among adolescents (10-19) and improving testing and treatment in adolescent populations are still unacceptably slow.

Around 120,000 adolescents live with HIV (UNAIDS 2017). The data also reveals a worrying gender disparity: according to IMASIDA 2015, HIV prevalence among adolescent girls 15-19 is four times higher than for boys (6.5% vs 1.5%). Prevalence is also higher in urban areas than in rural.  Young women have higher odds of HIV infection due to various factors including gender norms, reduced access to information, and age-disparate sex. Additionally, not knowing one’s HIV status and engaging in high risk practices predisposes young people to the risk of contracting HIV. This highlights the need for adolescents and young people to have access to appropriate information as they explore their sexuality.

The AIDS epidemic must remain a global public health concern, according to UNICEF and UNAIDS. Innovative solutions must be adopted to speed up progress in preventing HIV infection of children and adolescents and ensuring those living with HIV get the treatment they need. 

In 2015, in the context of the youth-focused Sexual and Reproductive Health (SRH) and HIV prevention Geração Biz (Busy Generation) programme, UNICEF Mozambique partnered with line ministries of Youth and Sports; Health; Education and Human Development; UNFPA and the youth association Coalizão (Youth Coalition) to adapt the SMS-based technology for development platform U-Report and roll out the programme known as SMS BIZ. This was aimed at improving adolescent and young people’s access to comprehensive and personalised SRH and HIV information through SMS (for more information visit http://mozambique.ureport.in/).

SMS BIZ partners set up a counselling hub managed by Coalizão with 24 trained peer counsellors, equipped with ICT facilities and a reference guide on SRH, HIV and Gender-based Violence (GBV) prevention to facilitate their capability to respond to adolescents queries. The counseling service is totally anonymous so neither the counsellors nor users can identify the other. Counsellors respond to about 1,000 questions daily. A total of 350,000 questions were responded to date. Communication and promotion materials were developed to promote the counselling service while advocacy sessions were held in selected provinces in order to create synergies with different stakeholders. Partnerships with the three Telecom Operators allowed SMS BIZ partners to count on free un-limited SMS for the period of 2017-2020.

In only two years, SMS BIZ/U-Report, has exceeded expectations with over 110,000 active adolescents and youth registered by September 2017, using the services for information on topics relevant to them.

Adolescents and young people registered have been engaged in discussions addressing misconceptions about SRH, HIV prevention and treatment, and increasing uptake and linkages to HIV and GBV services. Results from a poll show positive results, with 65% of adolescents and young people that responded to the poll were referred and adhered to health facilities during the counselling session for additional individual face-to-face counselling, consultation or treatment.

However, until recently, the challenge has been attracting as many girls as boys to the platform with a ratio of 60% boys - 40% girls. Raima Francisco Manjate, one of the SMS BIZ/U-Report stellar peer counsellors officially launched the Girl-to-Girl invite system on the International Day of the Girl Child on October 11th, with an intervention at the National Girls Conference organized in the context of the UN Joint programme Action for Girls, funded by the Swedish Government. The results have been outstanding: in 72 hours, more than 8,600 girls were successfully registered, the girls' user population grew from 4% to 44%, with five girls registering more than 50 friends and winning the competition.

Today, the total number of SMS BIZ/U-Report users reached 130,000.

The five adolescent and young girls, winners of the competition, have been awarded today at the World AIDS Day Celebrations, in Maputo and in the provincial capitals of Quelimane, Nampula and Beira in recognition of their efforts in mobilising friends to adhere to this important counselling service.

Neima Muianga, 20 years old and Cristina Djive, 18 years old,  both from the capital Maputo, were the two girls awarded today at the WAD ceremony, by the following high-level dignitaries such as Mr. Carlos Agostinho do Rosario, Mozambique Prime Minister, Mr. Luiz Loures, UNAIDS Deputy Executive Director, Ms. Nazira Abdul, Health Minister and Ms. Clarisse Machanguana, UNICEF National Ambassador.

Neima was thrilled when she discovered she had won the competition: “I feel happy about it. I have sent various SMS to contact numbers on my list, my neighbours, church members and even girls or young women I would bump into in the streets. SMS BIZ is very important for us. I don’t feel comfortable speaking with my parents about sexuality as this is taboo in Mozambique”.

"It is an excellent example of how young people can empower each other through technologies and innovative projects. Girl-to-Girl (G2G) is the kind of innovation that has an essential role for gender equality and health as we work to leave no one behind in implementing the sustainable development goals," said Luiz Loures, UNAIDS Deputy Executive Director, Assistant Secretary-General of the United Nations.

Now that the SMS BIZ/U-Report initiative has been scaled up at national level, SMS BIZ partners expect to reach and engage approximately 400,000 adolescents and young people by 2020. According to Cristina “this initiative cannot stop. So far, it has been a great experience for us.”

CAPE TOWN/GENEVA, 20 November 2017—The Executive Director of UNAIDS, Michel Sidibé, has appointed the Associate Scientific Director of the Centre for the AIDS Programme of Research in South Africa, Quarraisha Abdool Karim, as a UNAIDS Special Ambassador for Adolescents and HIV. The announcement was made in Cape Town during the launch of a new UNAIDS report, Right to health.

Professor Abdool Karim is one of the world’s leading AIDS researchers. She has made pioneering contributions to understanding the HIV epidemic among young people, especially among young women, and is a strong advocate for the rights of people living with and affected by HIV. In her new role as a UNAIDS Special Ambassador, she will focus on adolescents and HIV, while also championing the involvement of young women in science.

“I am delighted that Quarraisha Abdool Karim has accepted this position,” said Mr Sidibé. “A strong and consistent champion of young people living with and affected by HIV, she will use her new role to continue to translate scientific research and knowledge into people-centred solutions and prevention programmes to reduce the factors making young people so vulnerable to HIV infection. UNAIDS looks forward to supporting her work.”

Young people are particularly vulnerable to HIV. There were an estimated 610 000 new HIV infections among young people aged 15 to 24 in 2016, with young women accounting for 59% of new infections among this age group. In eastern and southern Africa, young women aged 15 to 24 years make up two thirds of new HIV infections among this age group.    

“As we increase our understanding of the HIV epidemic and the transmission dynamics that place young people at higher risk of infection, all sectors of society must work together to make sure that adolescents have access to the information and services that can keep them safe and well through a crucial period of their lives and into adulthood,” said Professor Abdool Karim.

Professor Abdool Karim is Professor in Clinical Epidemiology at the Mailman School of Public Health, Columbia University, United States of America, and an Honorary Professor in Public Health at the Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa. She is a member of the UNAIDS Scientific Expert Panel and Scientific Adviser to the Executive Director of UNAIDS.

In 2013, Professor Abdool Karim was awarded South Africa’s highest honour, the Order of Mapungubwe, for her contribution to the response to HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

When Camila fell in love with her high school classmate Henrique, she didn’t know he was born with HIV. It was only after an incident at school that his HIV status was revealed to everyone. She then made an informed decision to take his side and live their love story together facing the challenges imposed by stigma and discrimination among friends and family.

Their love story was one of the main plots of the 2015–2016 season of the teen soap opera Malhação—Seu Lugar No Mundo (Malhação—Your Place in the World), from author Emanuel Jacobina. The serodiscordant couple interpreted by actors Thales Cavalcanti (Henrique) and Manuela Llerena (Camila) became some of the most loved characters of the season, which counted on the consultancy support of UNAIDS for the zero discrimination and HIV-related scenes.

Success among fans was such that the couple #Camique won a spin-off web series on Globo’s online entertainment platform Gshow called Eu Só Quero Amar (Young Hearts—I Just Want to Love). The five-episode web series soon became a bit hit—from April to June 2016, it was the third most watched original series on the platform, with almost 1 million views. On 16 October 2017, it was nominated for the Emmy Kids 2017 in the digital category.

The project is a result of an effort to get HIV back on the agenda for young people in Brazil. For that, UNAIDS teamed up with Globo’s social responsibility branch and worked with Mr Jacobina and writers Filipe Lisboa and Giovana Moraes to tailor HIV and zero discrimination messages to a young audience. In the spin-off production, the serodiscordant couple from fiction are invited to be part of a web documentary, alongside real serodiscordant couples, talking about their relationships, sexuality and the impact of HIV in their daily lives.

“The message and the narrative of today’s HIV epidemic have to be adapted to young people,” explains Georgiana Braga-Orillard, UNAIDS Country Director in Brazil. “The web series managed to capture the essence of this communication.”

"The idea of the web series came from all the discussions I had with UNAIDS about HIV in Brazil in the 21st century. We realized that everything that needed to be told would fit better and more clearly in a specific series on the subject,” says Mr Jacobina. “I think it is a very important work that has helped Brazil to resume the discussion about HIV, clarifying the issue of prevention. I feel honored and proud with the nomination.”

Malhação is Globo’s longest running soap opera—on air for over two decades—and reaches an estimated daily audience of 20 million people in Brazil.

Watch the series

From 14 to 21 October, almost 25 000 young people from 188 countries gathered in Sochi, Russian Federation, for the XIX World Festival of Youth and Students. The festival provided a space for young people to unite in addressing global challenges, with a special focus on the Sustainable Development Goals (SDGs).

Through the leadership of the PACT youth coalition against HIV and with support from UNAIDS and participation of UNFPA and UNESCO, the issues of ending AIDS and sexual and reproductive health and rights were high on the agenda.

Three sessions focused on comprehensive sexuality education, modern epidemics and the role of young people in ending AIDS by 2030. The overarching theme of the discussions was that although much progress has been achieved in the response to HIV, there are still persistent challenges that put young people at risk, including discrimination, exclusion, violence and lack of access to services such as comprehensive sexuality education.

Speakers at the comprehensive sexuality education session highlighted that the absence of quality comprehensive sexuality education remains one of the largest gaps in ensuring that young people know how to protect themselves from HIV. Speakers also presented key new products and platforms, including a comprehensive sexuality education hub, teensLIVE.info, a video lesson developed for schoolchildren in eastern Europe and central Asia featuring UNAIDS Goodwill Ambassador Vera Brezhneva and a series of videos by the NauchPok channel.

The PACT youth coalition met with the United Nations Secretary-General’s Envoy on Youth, Jayathma Wickramanayake, who said, “I am looking forward to working with all of you through UNAIDS and other partners. My goal is to ensure that young people have a voice in all United Nations processes and to help them address issues that are relevant to them and their communities, including those issues that may be perceived as sensitive or challenging.”

Lack of access to information on HIV leads to new HIV infections and sustains the root causes that put young people at risk, including inequality, discrimination, violence and exclusion. Dilyara Vagapova, from the Russian rock group Murakami, said, “Without open conversations with young people about HIV, sex and the harm done by drugs, we will not succeed in ending the HIV epidemic in eastern Europe and central Asia.”

To ensure that the targets in the 2016 United Nations Political Declaration on Ending AIDS are met, accountability is key. Young leaders from Bulgaria, India, South Africa, Tajikistan, Ukraine and the United Kingdom of Great Britain and Northern Ireland shared best practices in peer education and youth-led accountability for the SDGs and the HIV response. Yana Mladenova from Bulgaria, said, “A policy on paper is not the same as a policy in practice. Successful advocacy results in action in practice.” Yana Valchuk, from the Teenergizer adolescent network, said, “To end the epidemic, we need to end discrimination, so adolescents stop living in fear.”

Vinay P. Saldanha, the UNAIDS Regional Director for Eastern Europe and Central Asia, spoke at several sessions. “Achieving the Sustainable Development Goals, including ending AIDS by 2030, does not depend on those that negotiated them. It depends on the personal commitment of each young person at this festival. This is your world—these are your goals!,” he said.

Adolescents and young people aged between 16 and 19 years from several countries in eastern Europe and central Asia met in Aghveran, Armenia, from 26 to 29 August for the first Teenergizer strategic planning meeting. They discussed the challenges faced by adolescents living with HIV in their countries, shared the results of the #questHIVtest project and developed the #Teenergizer2020 strategic plan.

Teenergizer is a unique movement of 80 adolescents born to mothers living with HIV and HIV-negative volunteers from Georgia, the Russian Federation and Ukraine. They are united by a set of common values, including support for engagement, tolerance and human rights.  

The issues addressed in the strategic plan include advocating for adolescents’ sexual and reproductive health and rights, the promotion of age-appropriate information on prevention for adolescents and engaging teenagers living with HIV to raise their voices in the HIV response.

In the #questHIVtest project, teams in Tbilisi in Georgia, Kiev and Poltava in Ukraine and Kazan and Saint Petersburg in the Russian Federation promoted easy, safe and youth-friendly HIV testing among adolescents.

Young people visited HIV testing sites and described the barriers to testing they faced. Using this information, they developed a map showing 63 HIV testing locations, accompanied by personal reviews on the HIV test experience, along with fun places nearby for young people to meet. As a result of the #questHIVtest, 1 925 adolescents from 5 cities have tested for HIV.

Max Saani, from Tbilisi, said, “It’s extremely helpful for teenagers to have a map on which adolescents can find youth-friendly testing locations and receive proper help and support.” “This map is very unusual, with fun teen places not even seen in Google Maps,” added Yana Valchuk, from Kiev.

Among the challenges and barriers faced by adolescents during the #questHIVtest were a lack of HIV information, stigma around HIV testing and talking about HIV with friends, the high cost of HIV tests and parental consent. The lack of anonymous HIV tests for young people and the shortage of trained doctors, social workers and psychologists to support adolescents living with HIV were also barriers.

Timur Khayarov, from Kazan, explained that the reasons why many adolescents in the Russian Federation are afraid to take an HIV test include the age limit—14 to take the test with parental consent, 16 without parental consent—and because the test results of minors must be communicated to their parents. “When I was refused an anonymous HIV test because of my age, I showed the personnel a printout of the law. The #questHIVtest helped me to defend my right to services,” he said.

The #questHIVtest project was undertaken with support from UNAIDS and the Viiv Healthcare Foundation.

“I’m convinced that the future is in the hands of adolescents—they are the people who will change and build a new world. By 2020, Teenergizer will be a few steps closer to the world that it seeks,” said Armen Agadjanov, an HIV activist from Yerevan, Armenia.

UNAIDS has been recognized for meeting or exceeding all of the 15 performance indicators of the United Nations System-wide Action Plan on Gender Equality and the Empowerment of Women (UN-SWAP), a year ahead of the deadline established by the United Nations System Chief Executives Board for Coordination.

In a letter sent by Phumzile Mlambo-Ngcuka, Executive Director of UN Women, to Michel Sidibé, Executive Director of UNAIDS, the organization is commended for its significant dedication to gender equality and women’s empowerment at all levels. UNAIDS has achieved overall gender parity at the professional and higher levels and has created an enabling work environment through extended maternity leave and flexible working conditions.

The findings of UN-SWAP reaffirm UNAIDS’ role as a leader for gender equality and the empowerment of women across the United Nations system. UNAIDS meets or exceeds the requirements of 100% of the UN-SWAP performance indicators, compared to only 64% for the overall United Nations system. In addition, UNAIDS exceeds the requirements for 53% of the indicators, compared to 19% for the overall United Nations system.

Since the inception of UN-SWAP, UNAIDS has demonstrated continued progress in each annual report and has commitment to improving its UN-SWAP scoring in at least one performance indicator over this year.

UN-SWAP is a United Nations system-wide accountability framework designed to measure, monitor and drive progress towards a common set of standards for the achievement of gender equality and the empowerment of women. Sixty-five entities, departments and offices of the United Nations system report on it every year.

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UNAIDS Regional Goodwill Ambassador for Latin America and the Caribbean and CNN Anchor Alejandra Oraa visited El Salvador from 9 to 11 August to raise awareness about strengthening HIV prevention efforts for adolescents and young people.

In El Salvador, there is a growing concern about the increase in new HIV infections reported since 2011 among adolescents aged between 15 and 19 years. Young people are not receiving the information they need to protect themselves from HIV: only 36.5% of young people aged 15–24 years know how to prevent HIV transmission.

During her visit, Ms Oraa met with youth leaders in order to analyse gaps in access by adolescents and young people to sexual and reproductive health and HIV-related services and comprehensive sexuality education. Young people stressed the need to urgently accelerate efforts to provide youth with the tools they need to make informed decisions to protect their health, rights and dignity.

Young people also talked about the initiatives in place to contribute to the HIV response from their perspective. For example, to improve access to information and education on HIV and sexual and reproductive health, the National Network of Positive Youth, in coordination with UNAIDS, the United Nations Population Fund and the National Youth Institute, organizes outreach awareness initiatives in public places and schools. Between Friends (Entre Amigos), a community-based organization, uses face-to-face approaches and offers combination prevention options for key populations, including young men who have sex with men and young transgender people.

In El Salvador, Ms Oraa leveraged her social media power to launch a new online survey to assess young people’s knowledge about HIV prevention and transmission. The findings of that United Nations Children’s Fund and UNAIDS joint initiative will be used to inform national public policies and strategies to prevent and reduce new HIV infections among young people. 

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Although new HIV infections and AIDS deaths among young people have decreased, in many places knowledge about how to prevent HIV remains worryingly low. Ahead of International Youth Day UNAIDS spoke to four young people about the challenges they face around HIV.

Pavel Gunaev is 16 years old and lives in St. Petersburg, where he is part of the youth-led network of adolescents and young people living with HIV Teenergizer! Pavel said that in his city young people are not aware about HIV.

“AIDS isn't talked about so young people don’t know about the risks or how to protect themselves from HIV,” he said. “As a result, so many uninformed young people are acting and making decisions based on rumors.” Pavel believes that if everyone does more to inform adolescents and young people and dispel the myths around HIV, ending AIDS will be possible.

Chinmay Modi was born with HIV twenty-three years ago. He is a member of the National Coalition of People Living with HIV in India and country focal point for the Youth LEAD Asia Pacific Network.

“The biggest problem is raising awareness and giving young people age-appropriate information,” he said. In his view, parents are not comfortable talking with their children about sex and society shies away from it too. As a result, he explained, young people are engaging in sex and experimenting new things but with little knowledge of the risks involved.

“Condoms need to be promoted and partners should support youth empowerment so that everyone is held accountable,” Chinmay said. He is also frustrated because in India people cannot access stigma-free HIV services at an early age.

In his view, self-stigma is hampering efforts to tackle discrimination, violence and inequalities related to HIV. That’s why, he explained, he wants more people to share their stories and be positive about being positive.

Moises Maciel couldn’t agree more with Chinmay. He is a 20-year-old LGBT and HIV activist. He became a  member of the National Network of Adolescents and Youth Living with HIV/AIDS in Brazil after discovering his positive HIV status two years ago. Since then, he has been on a journey against HIV-related stigma. He has also been motivating his peers to get tested.

“Young people are still at great risk of HIV infection due to a variety of factors such as social marginalization related to gender and racial inequalities,” he said. “In Brazil, young transgender and gay people are particularly targeted,” he explained.

He said that it baffles him to see how stigma and prejudice still dominate despite people living with HIV living healthy lives with the help of antiretroviral therapy. “We should start talking to young people in an open and responsible way about sexuality, sexually transmitted infections, teenage pregnancy and life responsibilities,” Moises said.

Lorraine Anyango, a Boston-based youth health and rights advocate, works to ensure that young people's voices, specifically around HIV, get heard.

“Young people continue to be left out of spaces and discussions on issues that impact their lives,” Lorraine said. “Their autonomy as individual human beings continues to go unacknowledged, leaving them susceptible to the risk of HIV infection.”

In her opinion, young people’s participation in decisions that affect their health can contribute to strengthen national-level accountability, by ensuring that programmes are effectively responding to their needs. Lorraine concluded by saying, “Recognizing youth sexual and reproductive health and rights, and continuing the conversation on HIV will get us closer to ending AIDS by 2030.”

Latin American and Caribbean countries have adopted the Santiago Commitment to Action for the Implementation of the Global Strategy for Women’s, Children’s and Adolescent’s Health. The Santiago Commitment to Action, which was adopted at the Every Woman, Every Child, Every Adolescent meeting held in Santiago de Chile from 2 to 4 July, saw the countries agree to work to end all preventable deaths, including AIDS-related deaths of women, children and adolescents by 2030, and to develop effective initiatives to ensuring their well-being.

The meeting, hosted by the President of Chile, Michelle Bachelet, saw regional ministers of health and social development and other experts come together. They discussed strategies to reduce inequalities and teenage pregnancy and to promote quality sexual and reproductive health and rights and HIV prevention and care.

The participants recognized that the health of women, children and adolescents is critically important to almost every area of human development and progress, and directly affects the achievement of the Sustainable Development Goals. The participants warned that inequalities affect and worsen overall health in society and represent the greatest threat to regional development.

With the Santiago Commitment to Action, participants agreed to strengthen universal access to health, including HIV-related services, with a human rights and life-cycle approach. They also agreed to develop an integrated programme for women, children and adolescents that guarantees access to HIV services and promotes cooperation and multisectoral actions within and between countries.

The meeting was also an opportunity to formally present the new coordinating mechanism for the Every Woman Every Child Global Strategy for Women’s, Children’s and Adolescents’ Health in the context of Latin America and the Caribbean, which unites seven organizations under the name Every Woman Every Child Latin America and the Caribbean. This initiative leverages the work done by A Promise Renewed for the Americas, which has transitioned to become the regional interagency coordination mechanism for the Every Woman Every Child Global Strategy.

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