Guidelines for HIV testing and counselling of adolescents IATT/YP meeting, Paris June 2011 Jane Ferguson, WHO

Why attention to HIV testing and counselling (HTC) of adolescents HTC is key entry point for HIV prevention interventions and is essential for access to care HTC coverage for adolescents is currently low (although increasing for young women through ANC/PMTCT). ART coverage is low, entry into care is late. Doubling HTC among young people is one of the key results of the UNAIDS YP business case

WHO guidelines development process Standard and compulsory for all WHO technical guidance Rigorous review of evidence of specific questions (PICOT) Quality of evidence assessed by GRADE methodology, supplemented by risk/benefit analysis External peer reviewers Formulate draft recommendations Consultations with civil society

PICOT questions Population – adolescents (e.g. M/F by age; Key Pop; etc.) Interventions – e.g. prevention education; training health workers Comparators – intervention or not Outcomes – e.g. access to care; acceptability Time -

Input please for the guidelines development! Buzz groups of 3 persons to provide: 1 question to answer Resource persons/institutions to involve Countries with examples of HTC services serving adolescents

Literature from 2003 onwards (inclusive) Describe HTC models in adolescents and young people: years old Describe existing models of HTC in both developed and developing countries Designed as randomised controlled trials, observational studies, questionnaire surveys, reviews etc Compare various testing models, looking at these specific issues: –Advantages and disadvantages of models –Guardian and parental issues –Barriers to testing approaches –Legal issues, consent age, procedures, confidentiality Special groups e.g. Men who have sex with men (MSM), intravenous drugs users (IVDUs) –Determine outcome measures and impact of testing models, including: –Positivity rate (detection/diagnosis) –Uptake rate –Referral success (to prevention and treatment/care services) –Uptake/maintenance/discontinuance of preventive behaviours –Stigma/discrimination –Psychosocial concerns Adolescent HTC - Literature review inclusion criteria (undertaken by Jennifer Hinners, Omar Abdel-Mannan)

2154 references retrieved from electronic database search 198 references 51 references considered eligible for review 147 excluded based on inclusion criteria 1956 references excluded from title and abstract review Literature review - Inclusion flow diagram

Next steps Proposal for guidelines development approved --- starting the work; hope to have expert panel December 2011 Developing scoping document for background to proposal for guidelines development for adolescents living with HIV/AIDS