New evidence on the impacts of violence on ART adherence amongst adolescents living with HIV

Case Studies & Research
3 p.

Eastern and Southern Africa is home to 70 per cent of adolescents, aged 10-19 years, living with HIV globally and have the highest rates of ART non-adherence. The consequences of which can result in elevated viral load, increased risk of onward HIV-transmission, AIDS-related morbidity, and mortality. Given global evidence of multiple negative impacts of violence on children’s mental and physical health, violence may also be an important contributor to ART non-adherence amongst adolescents. Violence Against Children Surveys (VACS) completed in 11 countries show high levels of violence exposure amongst this cohort, including 45 per cent of girls and 54 per cent of boys experiencing physical violence and 23 per cent of girls and 10 per cent of boys experiencing sexual and emotional violence. Experiencing or witnessing violence can lead to psychosocial factors that are associated with increased risk of non-adherence. New evidence from a longitudinal study of a 1090 adolescents living with HIV (10-19 years) in the Easter Cape, South Africa is showing promising results on the positive association between reduction of violence and risk of ART non-adherence for adolescents living with HIV from 75 per cent to 25 per cent. Furthermore, supportive parenting, social cash transfers and safe schools have all shown to decrease exposure to violence amongst all adolescents. This brief builds on effective responses in practice to prevent exposure to violence amongst adolescents, including strengthening screening to exposure of violence and improving linkages and referral pathways between prevention and response services and HIV care.

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