Recent trends in the Government of South Africa’s human immunodeficiency virus (HIV) treatment programs indicate that despite the rise in adolescents seeking treatment, many barriers still hinder care for adolescents living with HIV (ALWH). In a commentary written for The Lancet HIV, Dr. Audrey Pettifor, professor of epidemiology at the University of North Carolina Gillings School of Global Public Health, noted that these barriers can prevent ALWH from receiving and continuing treatment — or even being tested at all.
South Africa, currently the country with the largest number of people living with HIV, has made great strides in increasing the availability of HIV treatment. However, fewer than half of ALWH who sought care started antiretroviral therapy. These statistics fall short of the 90-90-90 target set by the Joint United Nations Programme on HIV and acquired immune deficiency syndrome (AIDS).
Common barriers to testing can include fear of the stigma of being tested, of learning the results or of having the confidentiality of said results breached. Other barriers include a lack of knowledge about the risks of infection and the availability of testing.
The subject of Dr. Pettifor’s commentary — a study led by Dr. Mhairi Maskew at the University of the Witwatersrand, South Africa – indicated that the gap in HIV care comes not only from lack of testing, but also from the insufficient rates with which HIV-diagnosed adolescents gain access to care and treatment. This is commonly referred to as “poor linkage in care.” Barriers that contribute to this poor linkage are similar to barriers in testing, but also can include poor treatment by health care providers, lack of adolescent-friendly care and denial about an HIV diagnosis.Friday Letter Submission, Publish on November 15